Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06639 | Date 15/10/2019 |
| Token No | SM/19-20/14419 02/12/2019 | Serial | 012 Last Visit: 06/12/2019 |
| Patient Name | Master SOURIK GHOSAL | Contact No | 9875554926 |
| Address | 35/2 CHATRA LANKAR BAGAN , BAIDYBATI(M) | Age | 2.4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||