Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01632 | Date 11/10/2018 |
| Token No | SM/18-19/2782 11/10/2018 | Serial | 045 Last Visit: 20/03/2019 |
| Patient Name | Master SAIKAT BHADRA | Contact No | 9883479900 |
| Address | CHATRA LANKAR BAGAN | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||