Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03769 | Date 21/02/2019 |
| Token No | SM/18-19/9198 21/02/2019 | Serial | 060 Last Visit: 21/02/2019 |
| Patient Name | Mr. KARTIK KOIRI | Contact No | 9088887044 |
| Address | 46 CHECK POST SARDAR PARA | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||