Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03733 | Date 20/02/2019 |
| Token No | SM/18-19/9122 20/02/2019 | Serial | 060 Last Visit: 20/02/2019 |
| Patient Name | Mr. BUBAI DAS | Contact No | 9062318161 |
| Address | CHATRA BAGER BAGAN, BAIDYABTI(M) | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||