Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02558 | Date 17/12/2018 |
| Token No | SM/18-19/5347 17/12/2018 | Serial | 028 Last Visit: 17/12/2018 |
| Patient Name | Mr. PANNALAL JESWAL | Contact No | |
| Address | 15 KAPUIYA PATTI | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||