Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01956 | Date 23/04/2019 |
| Token No | SM/18-19/3332 23/04/2019 | Serial | 003 |
| Patient Name | Mr. DEBENDAR JHA | Contact No | 9875348837 |
| Address | 100 R B SARANI | Age | 68 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||