Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03236 | Date 30/01/2019 |
| Token No | SM/18-19/7604 30/01/2019 | Serial | 034 Last Visit: 30/01/2019 |
| Patient Name | Mr. BIBEK JAISWAL | Contact No | 9748688950 |
| Address | 15,KAPORIYA PATTI LANE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||