Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00458 | Date 14/08/2018 |
| Token No | SM/18-19/5016 10/12/2018 | Serial | 064 Last Visit: 02/02/2019 |
| Patient Name | Mr. SAYAN LAHA | Contact No | 9163685518 |
| Address | CHATRA SHITALATALA | Age | 16.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||