Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01443 | Date 01/10/2018 |
| Token No | SM/18-19/2306 01/10/2018 | Serial | 026 Last Visit: 01/10/2018 |
| Patient Name | Mr. MD DILSAN | Contact No | 7044611156 |
| Address | 7, ARBINDA SARANI | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||