Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04363 | Date 25/03/2019 |
| Token No | SM/22-23/13903 23/06/2022 | Serial | 022 Last Visit: 23/06/2022 |
| Patient Name | Mr. SOURISH PANDIT | Contact No | 8479011877 |
| Address | 42 CHATRA KUMAR PARA SERAMPRE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||