Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01331 | Date 25/09/2018 |
| Token No | SM/18-19/2058 25/09/2018 | Serial | 040 Last Visit: 22/01/2019 |
| Patient Name | Mr. AMIT KR.SADHUKHA | Contact No | 8450848945 |
| Address | 2 OLD COURT LANE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||