Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 03521 | Date 12/02/2019 |
| Token No | SM/18-19/8504 12/02/2019 | Serial | 108 Last Visit: 12/02/2019 |
| Patient Name | Mr. HEMANT KUMARA MAHATO | Contact No | 8282986012 |
| Address | 16 K.M SAHA STREET | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||