Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01608 | Date 01/02/2019 |
| Token No | SM/18-19/2334 01/02/2019 | Serial | 006 |
| Patient Name | Mr. KRUSHNA BISWAL | Contact No | 9874292729 |
| Address | 8/434 INDIA JUTE MILL | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||