Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05465 | Date 18/06/2019 |
| Token No | SM/19-20/4758 18/06/2019 | Serial | 016 Last Visit: 18/06/2019 |
| Patient Name | Mr. SANATAN DAS | Contact No | 9062834950 |
| Address | KACHUTIA , KETUGRAM -I, BARDDHMAN | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||