Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02981 | Date 14/01/2019 |
| Token No | SM/19-20/12692 05/11/2019 | Serial | 066 Last Visit: 22/02/2020 |
| Patient Name | Mr. SIDDHARTHA SIULY | Contact No | 7890662724 |
| Address | TARARPUKUR | Age | 11 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 81 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||