Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05116 | Date 15/05/2019 |
| Token No | SM/19-20/2801 15/05/2019 | Serial | 041 Last Visit: 15/05/2019 |
| Patient Name | Mr. AYUSH DUTTA | Contact No | 8116732183 |
| Address | 17/2 CHATRA SHITLATALA , BAIDYABATI (M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||