Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00224 | Date 25/08/2018 |
| Token No | SM/18-19/241 25/08/2018 | Serial | 011 |
| Patient Name | Mr. BISHAL JAISWARA | Contact No | 8621048977 |
| Address | 7 DEY GHAT LANE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||