Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05766 | Date 13/07/2019 |
| Token No | SM/19-20/6450 13/07/2019 | Serial | 114 Last Visit: 13/07/2019 |
| Patient Name | Mr. SUDIP BELEL | Contact No | 9748022004 |
| Address | 117/57, LANKAR BAGAN SATCHASI PARA,BAIDYABATI(M) | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||