Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03650 | Date 18/02/2019 |
| Token No | SM/18-19/8899 18/02/2019 | Serial | 072 Last Visit: 18/02/2019 |
| Patient Name | Master ZENITH GHOSH | Contact No | 8240406247 |
| Address | 10A2 CHATRA GHOSH PARA 1 ST LANE | Age | 11 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||