Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03367 | Date 04/02/2019 |
| Token No | SM/18-19/8006 04/02/2019 | Serial | 102 Last Visit: 04/02/2019 |
| Patient Name | Mr. SK ARIYAN | Contact No | 8017963462 |
| Address | 41 CHATRA MUSALMAN PARA ROAD | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||