Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03355 | Date 04/02/2019 |
| Token No | SM/18-19/7974 04/02/2019 | Serial | 070 Last Visit: 04/02/2019 |
| Patient Name | Mr. ALI MALLICK | Contact No | 8444012446 |
| Address | CHATRA,ARABINDA SWARNI | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||