Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04745 | Date 17/04/2019 |
| Token No | SM/19-20/1064 17/04/2019 | Serial | 071 Last Visit: 24/04/2019 |
| Patient Name | Master SOUVIK DEY | Contact No | 9674467878 |
| Address | BAMUNARI MANSHA TALA RISHRA | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||