Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02640 | Date 21/12/2018 |
| Token No | SM/18-19/5607 21/12/2018 | Serial | 057 Last Visit: 21/12/2018 |
| Patient Name | Mr. SUSMIT DAS | Contact No | 9830685318 |
| Address | CHATRA CHOWDHURY PARA | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||