Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03991 | Date 05/03/2019 |
| Token No | SM/18-19/9826 05/03/2019 | Serial | 027 Last Visit: 05/03/2019 |
| Patient Name | Mr. MD ALTAF | Contact No | 8479042100 |
| Address | KANHAI DEWAN TALA SHEWRAPHULI, BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||