Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01251 | Date 20/09/2018 |
| Token No | SM/18-19/1884 20/09/2018 | Serial | 035 Last Visit: 20/09/2018 |
| Patient Name | Baby SWEETY | Contact No | |
| Address | G T ROAD | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||