Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02148 | Date 27/11/2018 |
| Token No | SM/18-19/4221 27/11/2018 | Serial | 013 Last Visit: 29/03/2019 |
| Patient Name | Mr. SUBHAM AHIR | Contact No | 9163163018 |
| Address | 7, P.N MUKHERJEE STREET | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||