Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00508 | Date 17/08/2018 |
| Token No | SM/18-19/5314 15/12/2018 | Serial | 046 Last Visit: 31/10/2019 |
| Patient Name | Mr. SK. IBRAHIM | Contact No | 9007755751 |
| Address | 4/A ARBINDO SARNI , CHATRA | Age | 9.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||