Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06083 | Date 07/08/2019 |
| Token No | SM/21-22/9015 17/01/2022 | Serial | 031 Last Visit: 26/03/2022 |
| Patient Name | Mr. NEMAI BAIRAGI | Contact No | 9903268518 |
| Address | 46/ A PATUA PARA SERAMPORE | Age | 84 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||