Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01720 | Date 27/10/2018 |
| Token No | SM/18-19/6089 31/12/2018 | Serial | 088 Last Visit: 13/05/2020 |
| Patient Name | Master MD AYAN | Contact No | 9874876616 |
| Address | CHATRA MUSALMAN PARA BY LANE | Age | 11 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||