Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01335 | Date 25/09/2018 |
| Token No | SM/18-19/2065 25/09/2018 | Serial | 047 Last Visit: 25/09/2018 |
| Patient Name | Master SUNIL RAM | Contact No | |
| Address | BAIDYABATI (M) | Age | 5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||