Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02727 | Date 28/12/2018 |
| Token No | SM/18-19/5942 28/12/2018 | Serial | 084 Last Visit: 28/12/2018 |
| Patient Name | Mr. JOYDIP DEY SARKER | Contact No | |
| Address | JHAPAN DANGA,BURDWAN | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||