Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02504 | Date 13/12/2018 |
| Token No | SM/18-19/5180 13/12/2018 | Serial | 027 Last Visit: 13/12/2018 |
| Patient Name | Mr. SHAMBHU NATH TIWARI | Contact No | 6291242475 |
| Address | CHATRA TELIPARA | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||