Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02026 | Date 03/05/2019 |
| Token No | SM/18-19/3533 03/05/2019 | Serial | 011 |
| Patient Name | Mr. PRATAP PRADHAN | Contact No | 8274050807 |
| Address | 9/442 INDIA JUTE MILL | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||