Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03800 | Date 22/02/2019 |
| Token No | SM/18-19/9283 22/02/2019 | Serial | 060 Last Visit: 22/02/2019 |
| Patient Name | Mr. DIPRA PATRA | Contact No | 6291471414 |
| Address | SANPUKUR DHAR BAURI PARA , BAIYABATI (M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||