Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01577 | Date 09/10/2018 |
| Token No | SM/18-19/2638 09/10/2018 | Serial | 027 Last Visit: 09/10/2018 |
| Patient Name | Mr. WASIM RAJA | Contact No | 9748284723 |
| Address | 24 PARSI LANE SRAMPORE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||