Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03024 | Date 16/01/2019 |
| Token No | SM/18-19/6891 16/01/2019 | Serial | 037 Last Visit: 16/01/2019 |
| Patient Name | Master SUBHO DAS | Contact No | 9836232595 |
| Address | CHATRA TETUL TALA | Age | 10 MONTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||