Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01401 | Date 28/09/2018 |
| Token No | SM/19-20/10515 17/09/2019 | Serial | 006 Last Visit: 04/06/2020 |
| Patient Name | Mr. SK SURAJ | Contact No | 9330994693 |
| Address | CHATRA MUSALMAN PARA | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||