Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04636 | Date 09/04/2019 |
| Token No | SM/19-20/552 09/04/2019 | Serial | 006 Last Visit: 09/04/2019 |
| Patient Name | Mr. SUSHIL KUMAR SHAW | Contact No | 9903254101 |
| Address | RAMKRISHNA NAGAR NICHU MATH, SHEORAPHULY, BAIDYABATI M | Age | 13Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||