Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06636 | Date 14/10/2019 |
| Token No | SM/19-20/12023 18/10/2019 | Serial | 043 Last Visit: 18/10/2019 |
| Patient Name | Mr. KALYAN GHOSH | Contact No | 9143220616 |
| Address | 299 G. T. ROAD,CHATRA,BAIDYABATI(M) | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||