Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00732 | Date 27/08/2018 |
| Token No | SM/18-19/905 27/08/2018 | Serial | 038 Last Visit: 27/08/2018 |
| Patient Name | Master IMTIYAJUDIN | Contact No | |
| Address | CHATUGANG ,CHATRA | Age | 5.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||