Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06845 | Date 13/11/2019 |
| Token No | SM/19-20/13126 13/11/2019 | Serial | 053 Last Visit: 13/11/2019 |
| Patient Name | Mr. ANUPAM DAS | Contact No | 9732222501 |
| Address | 19 NABIN CHAKRABORTY LANE CHATRA , BAIDYABTI(M) | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||