Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06168 | Date 20/08/2019 |
| Token No | SM/20-21/29248 11/01/2021 | Serial | 010 Last Visit: 11/01/2021 |
| Patient Name | Mr. SOUROJEET RUIDAS | Contact No | 9163632551 |
| Address | VILL- JALAGHATA SINGUR | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||