Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02854 | Date 07/01/2019 |
| Token No | SM/18-19/6373 07/01/2019 | Serial | 027 Last Visit: 21/08/2019 |
| Patient Name | Mr. PANA LAL JAISWAL | Contact No | |
| Address | 15 KAPURIYA PATTI SERAMPORE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||