Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 04837 | Date 22/04/2019 |
| Token No | SM/19-20/1408 22/04/2019 | Serial | 123 Last Visit: 22/04/2019 |
| Patient Name | Mr. SOUNAK MONDAL | Contact No | |
| Address | G T ROAD , BAIDYABATI(M) | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||