Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03549 | Date 13/02/2019 |
| Token No | SM/18-19/8586 13/02/2019 | Serial | 053 Last Visit: 13/02/2019 |
| Patient Name | Mr. MD KHALIJ | Contact No | 9748777088 |
| Address | 18 JUTE MIL(QUT.) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||