Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03840 | Date 23/02/2019 |
| Token No | SM/18-19/9376 23/02/2019 | Serial | 062 Last Visit: 23/02/2019 |
| Patient Name | Mr. AVIK GUPTA | Contact No | 9836798947 |
| Address | 96/E G T ROAD,TETULTALA,BAIDYABATI(M) | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||