Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03005 | Date 15/01/2019 |
| Token No | SM/19-20/1023 17/04/2019 | Serial | 030 Last Visit: 17/04/2019 |
| Patient Name | Mr. SUNNY JAISWAL | Contact No | 9748688950 |
| Address | 15 KAPURIYA PATTY TINBAJAR | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||