Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06121 | Date 16/08/2019 |
| Token No | SM/19-20/8460 16/08/2019 | Serial | 043 Last Visit: 29/08/2019 |
| Patient Name | Mr. SUMAN BERA | Contact No | 8017570295 |
| Address | 209/B TELIPARA BAGER BAGAN , BAIDYABATI(M) | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||