Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02155 | Date 31/05/2019 |
| Token No | SM/18-19/3901 31/05/2019 | Serial | 020 |
| Patient Name | Mr. GOUR BHAR | Contact No | 9830240397 |
| Address | 78 DEY STREET | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||