Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08959 | Date 10/11/2020 |
| Token No | SM/20-21/27402 10/11/2020 | Serial | 043 Last Visit: 10/11/2020 |
| Patient Name | Mr. TUSHAN MODAK | Contact No | 9831917576 |
| Address | CHATRA BOU BAZAR TELIPARA , BAIDYABATI(M) | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||