Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04235 | Date 15/03/2019 |
| Token No | SM/18-19/10596 15/03/2019 | Serial | 089 Last Visit: 15/03/2019 |
| Patient Name | Mr. MEET MANGUKIYA | Contact No | 9038533241 |
| Address | 61/A THAKUR DAS BABU LANE SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||