Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03333 | Date 02/02/2019 |
| Token No | SM/18-19/7892 02/02/2019 | Serial | 081 Last Visit: 02/02/2019 |
| Patient Name | Mr. SUBHAJIT JANA | Contact No | 9046495855 |
| Address | CHATRA ,G T ROAD,BAIDYABATI(M) | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||