Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01086 | Date 12/09/2018 |
| Token No | SM/18-19/1577 12/09/2018 | Serial | 043 Last Visit: 12/09/2018 |
| Patient Name | Master SK REHIM | Contact No | |
| Address | ARABINDA SARANI | Age | 9.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||