Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04836 | Date 22/04/2019 |
| Token No | SM/19-20/1406 22/04/2019 | Serial | 121 Last Visit: 22/04/2019 |
| Patient Name | Mr. NAUJAD HUSSAIN | Contact No | |
| Address | SHEWRAPHULI , BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||