Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01174 | Date 15/09/2018 |
| Token No | SM/18-19/1725 15/09/2018 | Serial | 045 Last Visit: 10/10/2018 |
| Patient Name | Mr. ATIB HUSSIAN | Contact No | 8444805902 |
| Address | 56 RAY GHAT LANE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||