Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05936 | Date 24/07/2019 |
| Token No | SM/19-20/7235 24/07/2019 | Serial | 077 Last Visit: 24/07/2019 |
| Patient Name | Mr. PIYUSH MUKHERJEE | Contact No | 9007120811 |
| Address | CHATRA GODAR BAGAN | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||