Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10212 | Date 22/10/2021 |
| Token No | SM/21-22/6081 22/10/2021 | Serial | 012 Last Visit: 22/10/2021 |
| Patient Name | Mr. ASHUTOSH KOLEY | Contact No | |
| Address | DIARA | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||