Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02802 | Date 03/01/2019 |
| Token No | SM/18-19/6191 03/01/2019 | Serial | 028 Last Visit: 18/01/2019 |
| Patient Name | Mr. SUVHAM DAS | Contact No | 9674675782 |
| Address | 18 D BIBEKANANDA LANE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||