Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01143 | Date 12/10/2018 |
| Token No | SM/18-19/1540 12/10/2018 | Serial | 013 |
| Patient Name | Mr. SAMPURNANANDA | Contact No | 9433457282 |
| Address | 308VIP APPARTMENT BOTTALA | Age | 24 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||