Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01499 | Date 04/10/2018 |
| Token No | SM/18-19/2431 04/10/2018 | Serial | 029 Last Visit: 05/12/2018 |
| Patient Name | Mr. SANTANU HALDER | Contact No | |
| Address | CHATRA BARUI PARA LANE SHIV TALA | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||