Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01856 | Date 02/11/2018 |
| Token No | SM/18-19/3646 14/11/2018 | Serial | 035 Last Visit: 14/11/2018 |
| Patient Name | Master SK ASHID | Contact No | |
| Address | BARO BELUR KAL TALA | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||