Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07640 | Date 27/02/2020 |
| Token No | SM/19-20/18723 27/02/2020 | Serial | 011 Last Visit: 27/02/2020 |
| Patient Name | Mr. RUPAM BELEL | Contact No | 9088877202 |
| Address | 117/6 SATCHASI PARA CHATRA , BAIDYABATI(M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||