Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05423 | Date 13/06/2019 |
| Token No | SM/19-20/4522 13/06/2019 | Serial | 077 Last Visit: 13/06/2019 |
| Patient Name | Mr. RANIT DAS | Contact No | 9830582086 |
| Address | 2/C PNK BANERJEE LANE CHTRA GHOSH PARA | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||