Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00167 | Date 18/08/2018 |
| Token No | SM/18-19/175 18/08/2018 | Serial | 011 |
| Patient Name | Mr. BHUBAN JAISWARA | Contact No | 9433668740 |
| Address | DEY BAGAN | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||