Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03990 | Date 05/03/2019 |
| Token No | SM/18-19/9824 05/03/2019 | Serial | 025 Last Visit: 05/03/2019 |
| Patient Name | Mr. CHAND BABU | Contact No | 7044291403 |
| Address | CHATRA MUSALMAN PARA | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||