Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02949 | Date 10/01/2019 |
| Token No | SM/18-19/6629 10/01/2019 | Serial | 056 Last Visit: 04/06/2020 |
| Patient Name | Master EKLAV SHAW | Contact No | 7980016787 |
| Address | 11 G.T ROAD CHAMPA ROAD, RISHRA | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||