Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01781 | Date 30/10/2018 |
| Token No | SM/18-19/3177 30/10/2018 | Serial | 048 Last Visit: 15/11/2018 |
| Patient Name | Master RITAM DUTTA | Contact No | 9874755487 |
| Address | CHATRA DUTTA PARA | Age | 4 YRS 8 MANTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||