Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03510 | Date 12/02/2019 |
| Token No | SM/18-19/8463 12/02/2019 | Serial | 067 Last Visit: 12/02/2019 |
| Patient Name | Mr. MD ALIM | Contact No | 8420973277 |
| Address | 7D ARBINDA SARNI CHATRA KUMAR PARA | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||