Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01357 | Date 11/12/2018 |
| Token No | SM/18-19/1927 11/12/2018 | Serial | 015 |
| Patient Name | Mr. RAJA SAMAN | Contact No | 8240874989 |
| Address | 9/486 INDIA JUTE MILL | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||