Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 08637 | Date 07/08/2020 |
| Token No | SM/19-20/24827 07/08/2020 | Serial | 034 Last Visit: 07/08/2020 |
| Patient Name | Mr. ASHISH MODAK | Contact No | 9830779549 |
| Address | 20 N. N. ROY STREET | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||