Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01933 | Date 18/04/2019 |
| Token No | SM/18-19/3271 18/04/2019 | Serial | 015 |
| Patient Name | Mr. SONU KR SHA | Contact No | NOT GIVEN |
| Address | 6 INDIAN JUTE MILL | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||