Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05836 | Date 19/07/2019 |
| Token No | SM/19-20/6830 19/07/2019 | Serial | 020 Last Visit: 19/07/2019 |
| Patient Name | Mr. ANKUSH DALUI | Contact No | 6291346371 |
| Address | 30/A KANAI DEWAN TALA LANE | Age | 7 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||