Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03652 | Date 18/02/2019 |
| Token No | SM/18-19/8901 18/02/2019 | Serial | 074 Last Visit: 18/02/2019 |
| Patient Name | Mr. RAVI SHAW | Contact No | 7003388692 |
| Address | 16 PATUA PARA | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||