Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09634 | Date 21/05/2021 |
| Token No | SM/21-22/2716 30/06/2021 | Serial | 022 Last Visit: 30/06/2021 |
| Patient Name | Master RUPAM DAS | Contact No | 8910251473 |
| Address | VIVEKANANDA SARANI NABAGRAM | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||