Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01565 | Date 09/10/2018 |
| Token No | SM/18-19/2615 09/10/2018 | Serial | 004 Last Visit: 09/10/2018 |
| Patient Name | Mr. SATRUGHAN MAHTA | Contact No | 9062763119 |
| Address | SIDESWARI TALA CHATRA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||