Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02127 | Date 26/11/2018 |
| Token No | SM/18-19/4159 26/11/2018 | Serial | 032 Last Visit: 26/11/2018 |
| Patient Name | Mr. SONTA BAGCHI | Contact No | 9836515118 |
| Address | 18 NO HORIMOHAN GOSWAMI STREET | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||