Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02051 | Date 10/05/2019 |
| Token No | SM/18-19/3603 10/05/2019 | Serial | 029 |
| Patient Name | Mr. RAJESH RAY | Contact No | 7634933656 |
| Address | JOLKOL WORKER | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||