Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01862 | Date 02/11/2018 |
| Token No | SM/18-19/5732 24/12/2018 | Serial | 055 Last Visit: 06/02/2019 |
| Patient Name | Mr. ANIK SARKAR | Contact No | 817569932 |
| Address | CHATRA SHITALALA | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||