Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02717 | Date 28/12/2018 |
| Token No | SM/18-19/5899 28/12/2018 | Serial | 041 Last Visit: 28/12/2018 |
| Patient Name | Mr. JOYDIP SOM | Contact No | 9836074282 |
| Address | 17 D CHATRA, DUTTA PARA LANE | Age | 10 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||