Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04288 | Date 18/03/2019 |
| Token No | SM/18-19/10789 18/03/2019 | Serial | 088 Last Visit: 04/04/2019 |
| Patient Name | Mr. RAJ MAHTO | Contact No | 8697302864 |
| Address | ARBINDA PARK CHECK POST | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||