Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00473 | Date 14/08/2018 |
| Token No | SM/18-19/3027 04/04/2019 | Serial | 002 |
| Patient Name | Mr. TRINATH BISWAL | Contact No | 8100218312 |
| Address | N L BHATTACHARYA ST | Age | 70 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||