Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02806 | Date 03/01/2019 |
| Token No | SM/18-19/10087 07/03/2019 | Serial | 090 Last Visit: 07/03/2019 |
| Patient Name | Mr. AYUSH GHOSH | Contact No | 9163680812 |
| Address | 8, A.P GHOSH ROAD CHATRA | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||