Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02691 | Date 27/12/2018 |
| Token No | SM/18-19/5792 27/12/2018 | Serial | 050 Last Visit: 27/12/2018 |
| Patient Name | Mr. SK SADDAM | Contact No | 9836369862 |
| Address | CHATRA MUSAL MAN PARA / LANE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||