Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04602 | Date 06/04/2019 |
| Token No | SM/19-20/431 06/04/2019 | Serial | 059 Last Visit: 13/07/2019 |
| Patient Name | Mr. SK SUMAN | Contact No | 9239868147 |
| Address | 20 CHATRA KUMER PARA | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||