Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03679 | Date 18/02/2019 |
| Token No | SM/18-19/8954 18/02/2019 | Serial | 127 Last Visit: 18/02/2019 |
| Patient Name | Mr. SOURV CHOWDHURY | Contact No | 9088692420 |
| Address | CHATRA TETULTALA MANIK GHOSER BAGAN, BAIDYABATI(M) | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||