Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05043 | Date 08/05/2019 |
| Token No | SM/19-20/2384 08/05/2019 | Serial | 075 Last Visit: 08/05/2019 |
| Patient Name | Mr. SOMA JALUI | Contact No | 8420175635 |
| Address | CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||