Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00776 | Date 28/08/2018 |
| Token No | SM/22-23/16064 27/08/2022 | Serial | 043 Last Visit: 27/08/2022 |
| Patient Name | Mr. OM DAS | Contact No | 7890210986 |
| Address | GODAR BAGAN BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||