Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05840 | Date 19/07/2019 |
| Token No | SM/19-20/22212 13/05/2020 | Serial | 020 Last Visit: 20/06/2020 |
| Patient Name | Mr. GOURAB MONDAL | Contact No | 8336953436 |
| Address | 33 A SIBTALA BOROBAGAN, | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||