Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05768 | Date 13/07/2019 |
| Token No | SM/19-20/6455 13/07/2019 | Serial | 119 Last Visit: 13/07/2019 |
| Patient Name | Mr. NUR MOHAMMAD | Contact No | |
| Address | MANIYAR MARGANGPAR,BIHR | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||