Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02505 | Date 13/12/2018 |
| Token No | SM/18-19/5181 13/12/2018 | Serial | 028 Last Visit: 13/12/2018 |
| Patient Name | Mr. RAM TIWARI | Contact No | 8478883283 |
| Address | CHATRA TELIPARA | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||