Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02569 | Date 17/12/2018 |
| Token No | SM/18-19/5388 17/12/2018 | Serial | 069 Last Visit: 17/12/2018 |
| Patient Name | Mr. PRIGANSHU CHAKRABORTY | Contact No | 9874548453 |
| Address | CHATRA TETUL TALA | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||