Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06475 | Date 19/09/2019 |
| Token No | SM/19-20/21766 30/04/2020 | Serial | 050 Last Visit: 30/04/2020 |
| Patient Name | Master SURYA KUMAR | Contact No | 8482031975 |
| Address | CHATRA MUSALMAN PARA | Age | 1 Y 6 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||