Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02198 | Date 29/11/2018 |
| Token No | SM/19-20/15394 16/12/2019 | Serial | 058 Last Visit: 16/12/2019 |
| Patient Name | Mr. SHYAM PANDIT | Contact No | 8479011877 |
| Address | 42 CHATRA KUMAR PARA | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||