Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04819 | Date 22/04/2019 |
| Token No | SM/19-20/8056 06/08/2019 | Serial | 077 Last Visit: 01/11/2019 |
| Patient Name | Mr. ISHAN BAIDHA | Contact No | 9674175417 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAODYABATI (M) | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||