Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07121 | Date 11/12/2019 |
| Token No | SM/19-20/15051 11/12/2019 | Serial | 030 Last Visit: 11/12/2019 |
| Patient Name | Mr. DIPLP DAS | Contact No | 9051884430 |
| Address | MOLLASIMLA,DEARA | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||