Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03444 | Date 07/02/2019 |
| Token No | SM/18-19/8260 07/02/2019 | Serial | 087 Last Visit: 27/04/2019 |
| Patient Name | Mr. SK ROHIT | Contact No | 6290116545 |
| Address | 21 CHATRA MUSALMAN PARA | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||