Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01131 | Date 14/09/2018 |
| Token No | SM/18-19/2410 04/10/2018 | Serial | 008 Last Visit: 04/10/2018 |
| Patient Name | Master SANU KUMARA SARAB | Contact No | 7449808305 |
| Address | TELI PARA BRUI BAGAN | Age | 3 MNTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||