Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03592 | Date 15/02/2019 |
| Token No | SM/18-19/8731 15/02/2019 | Serial | 019 Last Visit: 15/02/2019 |
| Patient Name | Master HASIB KHAN | Contact No | |
| Address | BOROBELUR,KALTALA | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||