Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 00087 | Date 12/09/2019 |
| Token No | SM/19-20/93 12/09/2019 | Serial | 010 |
| Patient Name | Mr. ACHHELAL SHAW | Contact No | 9681207938 |
| Address | 1/B 25 S S ROAD EXTENSION RISHRA PRAVASHNAGAR | Age | 80 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 170/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||