Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07056 | Date 03/12/2019 |
| Token No | SM/19-20/14585 03/12/2019 | Serial | 068 Last Visit: 08/01/2020 |
| Patient Name | Mr. DEB MANA | Contact No | |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYBATI(M) | Age | 5.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||