Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05930 | Date 24/07/2019 |
| Token No | SM/19-20/7209 24/07/2019 | Serial | 051 Last Visit: 09/08/2019 |
| Patient Name | Master JIYAN BANIK | Contact No | 9062932050 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 1.2 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||