Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02842 | Date 05/01/2019 |
| Token No | SM/18-19/6331 05/01/2019 | Serial | 046 Last Visit: 05/01/2019 |
| Patient Name | Mr. GOPAL KALWAR | Contact No | 9830886796 |
| Address | 39 ROY GHAT LANE | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||