Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02596 | Date 19/12/2018 |
| Token No | SM/18-19/5470 19/12/2018 | Serial | 034 Last Visit: 19/12/2018 |
| Patient Name | Mr. JAYDEEP DAS | Contact No | 9674856143 |
| Address | CHTARA DAS PARA , BAIDYABATI (M) | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||