Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05780 | Date 15/07/2019 |
| Token No | SM/19-20/6528 15/07/2019 | Serial | 071 Last Visit: 15/07/2019 |
| Patient Name | Master MD SAMAR | Contact No | 7998883472 |
| Address | MUSALMANPARA CHATRA | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||