Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01460 | Date 01/10/2018 |
| Token No | SM/18-19/2330 01/10/2018 | Serial | 050 Last Visit: 22/08/2019 |
| Patient Name | Baby SK ROHAN | Contact No | |
| Address | 12, CHATRA MUSALMAN PRA | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||