Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04363 | Date 25/03/2019 |
| Token No | SM/18-19/11627 30/03/2019 | Serial | 042 Last Visit: 23/06/2022 |
| Patient Name | Mr. SOURISH PANDIT | Contact No | 8479011877 |
| Address | 42 CHATRA KUMAR PARA SERAMPRE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||