Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10315 | Date 22/11/2021 |
| Token No | SM/21-22/6981 22/11/2021 | Serial | 021 Last Visit: 22/11/2021 |
| Patient Name | Mr. ARPIT GUPTA | Contact No | 8981241931 |
| Address | NISTARINI KALI BARI SHEORAPHULI | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||