Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02436 | Date 10/12/2018 |
| Token No | SM/18-19/5096 12/12/2018 | Serial | 010 Last Visit: 12/12/2018 |
| Patient Name | Master ANSH GUPTA | Contact No | |
| Address | 22/D CHATRA KUMAR PARA | Age | 3 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||