Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07197 | Date 20/12/2019 |
| Token No | SM/19-20/15651 20/12/2019 | Serial | 020 Last Visit: 20/12/2019 |
| Patient Name | Mr. ARPAN DHUL | Contact No | 8444067730 |
| Address | 76/1 CHATRA SHITLATALA BAGER BAGAN , BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||