Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03694 | Date 19/02/2019 |
| Token No | SM/18-19/9005 19/02/2019 | Serial | 035 Last Visit: 19/02/2019 |
| Patient Name | Mr. SK RAHIT | Contact No | 7890818112 |
| Address | CHATRA MUSALMAN PARA | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||