Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01825 | Date 28/03/2019 |
| Token No | SM/18-19/2923 28/03/2019 | Serial | 003 |
| Patient Name | Mr. RAGHU PRADHAN | Contact No | 9163765281 |
| Address | 10 NO. LINE | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||