Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02989 | Date 14/01/2019 |
| Token No | SM/18-19/6755 14/01/2019 | Serial | 046 Last Visit: 14/01/2019 |
| Patient Name | Mr. SK ANISH | Contact No | |
| Address | 21 CHATRA MUSALMAN PARA | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||