Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05798 | Date 16/07/2019 |
| Token No | SM/20-21/25869 21/09/2020 | Serial | 019 Last Visit: 21/09/2020 |
| Patient Name | Mr. SK SAMIM | Contact No | 9875427846 |
| Address | 20,KANAI DEOWAN TALA | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||