Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03617 | Date 16/02/2019 |
| Token No | SM/18-19/8812 16/02/2019 | Serial | 036 Last Visit: 29/04/2019 |
| Patient Name | Mr. BISHAL PARUI | Contact No | 9874679664 |
| Address | 181, CHATRA,BAGHER BAGAN,BAIDYABATI(M) | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||