Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07329 | Date 13/01/2020 |
| Token No | SM/19-20/16603 13/01/2020 | Serial | 005 Last Visit: 13/01/2020 |
| Patient Name | Mr. SK ASIR | Contact No | 9143124320 |
| Address | 21 K.D ROAD, BAIDYABATI(M) | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||