Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01553 | Date 06/10/2018 |
| Token No | SM/18-19/2580 06/10/2018 | Serial | 040 Last Visit: 06/10/2018 |
| Patient Name | Mr. SK SARUKH | Contact No | 9038161940 |
| Address | CHATRA MUSALAMAN PARA /LANE | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||