Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02603 | Date 20/12/2018 |
| Token No | SM/18-19/6384 07/01/2019 | Serial | 038 Last Visit: 07/01/2019 |
| Patient Name | Mr. RONI SADHUKHAN | Contact No | 9674813579 |
| Address | CHATRA DHARMOTALA | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||