Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06782 | Date 01/11/2019 |
| Token No | SM/19-20/12623 01/11/2019 | Serial | 070 Last Visit: 01/11/2019 |
| Patient Name | Master SUJAY PANDIT | Contact No | 9051070502 |
| Address | 75 A CHATRA BAGHER BAGAN | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||