Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10017 | Date 01/09/2021 |
| Token No | SM/21-22/4743 04/09/2021 | Serial | 012 Last Visit: 20/09/2021 |
| Patient Name | Mr. SK SAHIM | Contact No | 6291318450 |
| Address | 6/B KANAIDEON TALA LANE, | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||