Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08181 | Date 30/04/2020 |
| Token No | SM/19-20/21775 30/04/2020 | Serial | 059 Last Visit: 30/04/2020 |
| Patient Name | Other DAMAGED ITEMS | Contact No | |
| Address | UPHC-II | Age | 1 Year Other |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||