Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02094 | Date 22/11/2018 |
| Token No | SM/18-19/4053 22/11/2018 | Serial | 048 Last Visit: 22/11/2018 |
| Patient Name | Master RITAM DUTTA | Contact No | 8981872068 |
| Address | CHATRA DUTTA PARA | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||