Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06471 | Date 19/09/2019 |
| Token No | SM/19-20/10686 19/09/2019 | Serial | 068 Last Visit: 19/09/2019 |
| Patient Name | Master SHAKTI DAS | Contact No | 8100467336 |
| Address | CHATRA BAGER BAGN TELI PARA , BAIDYBATI(M) | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||