Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04013 | Date 05/03/2019 |
| Token No | SM/18-19/9872 05/03/2019 | Serial | 073 Last Visit: 03/03/2021 |
| Patient Name | Mr. SK ARMAN | Contact No | 9073429385 |
| Address | 9 ARBINDA SARANI CHATRA MUSALMAN PARA | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||