Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02058 | Date 20/11/2018 |
| Token No | SM/18-19/7521 29/01/2019 | Serial | 014 Last Visit: 29/01/2019 |
| Patient Name | Master SRISHNENDU HALDAR | Contact No | 9748957825 |
| Address | KALIBABU GHAT CHATRA | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||