Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03863 | Date 25/02/2019 |
| Token No | SM/18-19/9840 05/03/2019 | Serial | 041 Last Visit: 30/05/2019 |
| Patient Name | Mr. RUPANKER ADHIKARI | Contact No | 8420336639 |
| Address | 207 BAGER BAGAN,BAIDYABATI(M) | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||