Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01550 | Date 04/01/2019 |
| Token No | SM/18-19/2704 07/03/2019 | Serial | 016 |
| Patient Name | Mr. SHANKAR RAM | Contact No | 9477228074 |
| Address | 7 DEY GHAT LANE | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||