Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01829 | Date 01/11/2018 |
| Token No | SM/19-20/7787 02/08/2019 | Serial | 019 Last Visit: 02/08/2019 |
| Patient Name | Master SUROJIT MONDAL | Contact No | 9836855311 |
| Address | 164, CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 4 Y 6 M Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||