Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02750 | Date 31/12/2018 |
| Token No | SM/18-19/6012 31/12/2018 | Serial | 011 Last Visit: 31/12/2018 |
| Patient Name | Mr. SAPTAK GHOSH | Contact No | 9051714979 |
| Address | 31/A/1 CHATRA CHOWDHURY PARA LANE | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||