Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02896 | Date 08/01/2019 |
| Token No | SM/19-20/8124 07/08/2019 | Serial | 067 Last Visit: 30/09/2019 |
| Patient Name | Mr. ARIJIT DEY | Contact No | 9088164721 |
| Address | 1 CHATRA MUKHERJEE PARA | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||