Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00157 | Date 06/08/2018 |
| Token No | SM/18-19/244 08/08/2018 | Serial | 010 Last Visit: 08/08/2018 |
| Patient Name | Mr. IMRAN HUSSAIN MALLIK | Contact No | |
| Address | 8/A, MUSLMAN PARA,CHATRA | Age | 8.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||