Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03030 | Date 16/01/2019 |
| Token No | SM/18-19/6904 16/01/2019 | Serial | 050 Last Visit: 17/01/2019 |
| Patient Name | Mr. SK SALAM | Contact No | 8697774318 |
| Address | CHATRA KUMAR PARA | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||