Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00666 | Date 24/08/2018 |
| Token No | SM/18-19/811 24/08/2018 | Serial | 009 Last Visit: 24/08/2018 |
| Patient Name | Mr. SONA DAS | Contact No | |
| Address | PAMPA NAGAR , BAIDYABATI (M) | Age | 12.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||