Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00890 | Date 04/09/2018 |
| Token No | SM/21-22/1069 03/05/2021 | Serial | 017 Last Visit: 03/05/2021 |
| Patient Name | Mr. SK SAUKUT | Contact No | |
| Address | 17/A, CHATRA M.P/ LANE | Age | 65 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||