Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 00309 | Date 10/08/2018 |
| Token No | SM/18-19/2905 26/10/2018 | Serial | 019 Last Visit: 13/09/2019 |
| Patient Name | Mr. SANI JAISWAL | Contact No | 9748688950 |
| Address | 15, KAPURIYA PATI LANE , TINBAJAR | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||