Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04841 | Date 22/04/2019 |
| Token No | SM/19-20/1414 22/04/2019 | Serial | 129 Last Visit: 22/04/2019 |
| Patient Name | Mr. MD MOTAB | Contact No | |
| Address | KHAR PARA BAIDYABATI(M) | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||