Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02123 | Date 26/11/2018 |
| Token No | SM/18-19/4401 29/11/2018 | Serial | 062 Last Visit: 29/11/2018 |
| Patient Name | Mr. RANA BISWAS | Contact No | 9073229082 |
| Address | 23 NO ROY GHAT LANE | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||