Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03914 | Date 28/02/2019 |
| Token No | SM/18-19/9606 28/02/2019 | Serial | 028 Last Visit: 28/02/2019 |
| Patient Name | Master ARFAT ALI | Contact No | |
| Address | 26 K. D. LANE | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||