Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03534 | Date 13/02/2019 |
| Token No | SM/18-19/8540 13/02/2019 | Serial | 007 Last Visit: 13/02/2019 |
| Patient Name | Mr. PRINC DHARA | Contact No | |
| Address | BARA BHARMPUR | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||