Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01994 | Date 15/11/2018 |
| Token No | SM/18-19/8637 14/02/2019 | Serial | 002 Last Visit: 14/02/2019 |
| Patient Name | Mr. SK WASIM | Contact No | 8609952602 |
| Address | 5 ARABINDA SWARANI, | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||