Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03050 | Date 17/01/2019 |
| Token No | SM/18-19/6978 17/01/2019 | Serial | 058 Last Visit: 17/01/2019 |
| Patient Name | Mr. BHAGWAN SHAW | Contact No | |
| Address | N.S AVENUE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||