Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00106 | Date 13/09/2019 |
| Token No | SM/19-20/2973 11/03/2020 | Serial | 027 |
| Patient Name | Mr. DHARAM RAJ TIWARI | Contact No | 6290765374 |
| Address | 97/K/1 PRAVASHNAGAR SERAMPORE 712249 | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||