Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02756 | Date 31/12/2018 |
| Token No | SM/18-19/6030 31/12/2018 | Serial | 029 Last Visit: 31/12/2018 |
| Patient Name | Mr. RAJA DAS | Contact No | 7605878899 |
| Address | BHATTACHARJEE GARDEN,BAIDYABATY(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||