Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02168 | Date 28/11/2018 |
| Token No | SM/18-19/4270 28/11/2018 | Serial | 002 Last Visit: 01/12/2018 |
| Patient Name | Mr. SOBHAM LAHA | Contact No | 9330021570 |
| Address | 26, BARUI PARA LANE CHATRA | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||