Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01843 | Date 29/03/2019 |
| Token No | SM/18-19/2977 29/03/2019 | Serial | 025 |
| Patient Name | Mr. BHOJJU JAISWARA | Contact No | NOT GIVEN |
| Address | 7 NO DEY GHAT LANE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||