Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02730 | Date 29/12/2018 |
| Token No | SM/19-20/8812 20/08/2019 | Serial | 091 Last Visit: 20/08/2019 |
| Patient Name | Mr. GAMA KAIRY | Contact No | 8777278256 |
| Address | 21 LAL BAHADUR SASTRY ROAD | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||