Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06085 | Date 07/08/2019 |
| Token No | SM/19-20/8131 07/08/2019 | Serial | 074 Last Visit: 07/08/2019 |
| Patient Name | Mr. SUMIT PAL | Contact No | 8981218895 |
| Address | ADISAPTAGRAM, BANDEL | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||