Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03253 | Date 31/01/2019 |
| Token No | SM/19-20/14964 09/12/2019 | Serial | 074 Last Visit: 09/12/2019 |
| Patient Name | Mr. SUBHANKER HALDER | Contact No | 9674039044 |
| Address | BAGHER BAGAN,BAIDYABATY(M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||