Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06602 | Date 10/10/2019 |
| Token No | SM/19-20/13967 25/11/2019 | Serial | 076 Last Visit: 06/03/2021 |
| Patient Name | Mr. ABHI SAMANTA | Contact No | 7278128540 |
| Address | 31/1/1 GT ROAD , BAGER BAGAN, BAIDYABATI(M) | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||