Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00733 | Date 27/08/2018 |
| Token No | SM/18-19/906 27/08/2018 | Serial | 039 Last Visit: 27/08/2018 |
| Patient Name | Master SHIBAYAN MANA | Contact No | |
| Address | CHATRA HOOGHLY | Age | 5.6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||