Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05741 | Date 11/07/2019 |
| Token No | SM/19-20/6328 11/07/2019 | Serial | 078 Last Visit: 11/07/2019 |
| Patient Name | Mr. SHIBAJIT YADAV | Contact No | 9836262667 |
| Address | 2 CHOWDHURI PARA LANE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||