Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04089 | Date 08/03/2019 |
| Token No | SM/19-20/9423 29/08/2019 | Serial | 064 Last Visit: 29/08/2019 |
| Patient Name | Mr. PRIYANSHU SHA | Contact No | 9432592886 |
| Address | CHATRA SHITLATALA , BAIDYABATI(M) | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||