Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03668 | Date 18/02/2019 |
| Token No | SM/18-19/8932 18/02/2019 | Serial | 105 Last Visit: 18/02/2019 |
| Patient Name | Mr. SOURAV MALIK | Contact No | 9681230435 |
| Address | CHATRA SHITLATALA , BAIDYABATI (M) | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||