Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01310 | Date 24/09/2018 |
| Token No | SM/18-19/2000 24/09/2018 | Serial | 059 Last Visit: 24/09/2018 |
| Patient Name | Master SK TAIBE | Contact No | 9874066615 |
| Address | SEORAPHULY,MUSALMAN PARA | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||