Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03180 | Date 25/01/2019 |
| Token No | SM/18-19/7718 31/01/2019 | Serial | 092 Last Visit: 31/01/2019 |
| Patient Name | Master SK AYUSH | Contact No | 8820217073 |
| Address | 7/D ARBINDA SARANI CHATRA | Age | 3.3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||