Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04689 | Date 12/04/2019 |
| Token No | SM/19-20/824 12/04/2019 | Serial | 061 Last Visit: 17/04/2019 |
| Patient Name | Mr. SUBHO DAS | Contact No | 6290146201 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABTI(M) | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||