Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01589 | Date 17/01/2019 |
| Token No | SM/18-19/2297 17/01/2019 | Serial | 012 |
| Patient Name | Mr. PHASKAR PRADHAN | Contact No | 9748231069 |
| Address | 9 NO LINE | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||