Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05359 | Date 08/06/2019 |
| Token No | SM/19-20/4198 08/06/2019 | Serial | 046 Last Visit: 08/06/2019 |
| Patient Name | Mr. SHAN MD | Contact No | 9748303030 |
| Address | CHATRA MUSALMANPARA SHEORAPHULI | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||