Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 05782 | Date 15/07/2019 |
| Token No | SM/19-20/6531 15/07/2019 | Serial | 074 Last Visit: 15/07/2019 |
| Patient Name | Mr. SOHEL MALLICK | Contact No | 8478006237 |
| Address | NASIBPUR MOLLA SIMLA | Age | 6.5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||