Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02463 | Date 11/12/2018 |
| Token No | SM/19-20/13464 18/11/2019 | Serial | 039 Last Visit: 26/03/2020 |
| Patient Name | Mr. MONOMOY PAL | Contact No | 9062236122 |
| Address | 8A/1 CHATRA KUMAR PARA | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||