Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07248 | Date 30/12/2019 |
| Token No | SM/19-20/16020 30/12/2019 | Serial | 009 Last Visit: 30/12/2019 |
| Patient Name | Master DIP MALAKAR | Contact No | 7044353922 |
| Address | 16/18 G D BHATTACHARJEE LANE CHATRA BAIDYABATI | Age | 5 Months Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||