Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00300 | Date 10/08/2018 |
| Token No | SM/18-19/5995 29/12/2018 | Serial | 050 Last Visit: 20/07/2022 |
| Patient Name | Mr. GOURAB DAS | Contact No | 9331692582 |
| Address | 29/D DOLTAL CHATRA | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||