Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01676 | Date 15/02/2019 |
| Token No | SM/18-19/2478 15/02/2019 | Serial | 007 |
| Patient Name | Mr. SOMNATH MALIK | Contact No | 9748022665 |
| Address | 9 A B GARDEN LANE | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||