Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05693 | Date 08/07/2019 |
| Token No | SM/19-20/6029 08/07/2019 | Serial | 002 Last Visit: 08/07/2019 |
| Patient Name | Mr. MD JAHID | Contact No | 7890600731 |
| Address | 42 PANCHU GOPAL SARANI,TINBAZAR | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||