Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06323 | Date 03/09/2019 |
| Token No | SM/19-20/10600 18/09/2019 | Serial | 021 Last Visit: 18/09/2019 |
| Patient Name | Mr. GOBARDHAN RAM | Contact No | 7250323205 |
| Address | AMULKANAN NEAR E.S.I HOSPITAL | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||