Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03907 | Date 28/02/2019 |
| Token No | SM/18-19/9592 28/02/2019 | Serial | 014 Last Visit: 28/02/2019 |
| Patient Name | Mr. DEBASHIS DAS | Contact No | 9748029339 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||