Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00321 | Date 10/08/2018 |
| Token No | SM/18-19/347 10/08/2018 | Serial | 035 Last Visit: 10/08/2018 |
| Patient Name | Baby ANSU SINGH | Contact No | |
| Address | SHEWRAPHULI | Age | 5.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||