Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05361 | Date 08/06/2019 |
| Token No | SM/19-20/4200 08/06/2019 | Serial | 048 Last Visit: 08/06/2019 |
| Patient Name | Mr. BISWAJIT PAL | Contact No | 7059677180 |
| Address | CHATRA TETULTALA | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||