Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07408 | Date 24/01/2020 |
| Token No | SM/19-20/17091 24/01/2020 | Serial | 006 Last Visit: 27/02/2020 |
| Patient Name | Mr. SUMIT MITRA | Contact No | 7890756980 |
| Address | 24 BAGER BAGAN , CHATRA , BAIDYBATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||