Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02017 | Date 02/05/2019 |
| Token No | SM/18-19/3503 02/05/2019 | Serial | 012 |
| Patient Name | Mr. JEET JAISWARA | Contact No | 8981869058 |
| Address | 2 GOPAL GANGULY LANE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||