Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06177 | Date 20/08/2019 |
| Token No | SM/19-20/8835 20/08/2019 | Serial | 114 Last Visit: 20/08/2019 |
| Patient Name | Mr. SUBRATA DAS | Contact No | 9875691856 |
| Address | CHATRA BOU BAZAR , BAIDYABATI (M) | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||