Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00595 | Date 20/08/2018 |
| Token No | SM/18-19/702 20/08/2018 | Serial | 046 Last Visit: 20/08/2018 |
| Patient Name | Master RAHUL BANIK | Contact No | 9903870929 |
| Address | 208, BAGER BAGAN CHATRA | Age | 5.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||