Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01785 | Date 12/03/2019 |
| Token No | SM/18-19/2796 12/03/2019 | Serial | 012 |
| Patient Name | Mr. MONOJ PAL | Contact No | |
| Address | 5 RUDRA RAM PANDIT LANE | Age | 89 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||