Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05662 | Date 05/07/2019 |
| Token No | SM/19-20/5864 05/07/2019 | Serial | 027 Last Visit: 14/09/2019 |
| Patient Name | Mr. SK SADAK | Contact No | 9051339807 |
| Address | 17 CHATRA KUMOR PARA /LANE | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||