Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04828 | Date 22/04/2019 |
| Token No | SM/19-20/1395 22/04/2019 | Serial | 110 Last Visit: 22/04/2019 |
| Patient Name | Mr. ROHIT SINGH | Contact No | 9334567852 |
| Address | MARADAN , BAIDYABATI(M) | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||