Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06265 | Date 29/08/2019 |
| Token No | SM/19-20/9398 29/08/2019 | Serial | 039 Last Visit: 30/08/2019 |
| Patient Name | Mr. RABI DALUI | Contact No | 8336804389 |
| Address | KANAI DEOWAN TALA BYE LANE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 86 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||