Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00713 | Date 27/08/2018 |
| Token No | SM/18-19/882 27/08/2018 | Serial | 015 Last Visit: 27/08/2018 |
| Patient Name | Mr. SK IMRAN ALI | Contact No | 7890084199 |
| Address | 5 CHATRA ARABINDA SARANI | Age | 6.5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||