Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04937 | Date 27/04/2019 |
| Token No | SM/19-20/1780 27/04/2019 | Serial | 029 Last Visit: 27/04/2019 |
| Patient Name | Mr. VIVEK JAISWAL | Contact No | 9048513706 |
| Address | 15 KAPURIYA PATTI LANE SERAMPORE | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||