Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06667 | Date 17/10/2019 |
| Token No | SM/19-20/11905 17/10/2019 | Serial | 015 Last Visit: 17/10/2019 |
| Patient Name | Mr. GRISH YADAV | Contact No | 8585876359 |
| Address | 19 MUSALMAN PARA ROAD SHEWRAPHULI CHATUGANG | Age | 2 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||