Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02347 | Date 05/12/2018 |
| Token No | SM/18-19/4707 05/12/2018 | Serial | 031 Last Visit: 05/12/2018 |
| Patient Name | Master BABAI BHATTCHARJEE | Contact No | 8479985279 |
| Address | CHATRA MUSALMAN PARA | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||