Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05094 | Date 13/05/2019 |
| Token No | SM/19-20/2654 13/05/2019 | Serial | 065 Last Visit: 13/05/2019 |
| Patient Name | Master SK AYAN | Contact No | 7449644348 |
| Address | MALLIK PARA MIA DARJI LANE | Age | 3.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||