Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04485 | Date 30/03/2019 |
| Token No | SM/18-19/11642 30/03/2019 | Serial | 057 Last Visit: 30/03/2019 |
| Patient Name | Mr. RAJENDER RAJAK | Contact No | 9748050015 |
| Address | 5A KANHAI DEWAN TALA SERAMPORE (M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||