Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01048 | Date 05/10/2018 |
| Token No | SM/18-19/1368 05/10/2018 | Serial | 009 |
| Patient Name | Mr. JANMINJOY PATRA | Contact No | 9477161303 |
| Address | JAL KAL OFFICE | Age | 32 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||