Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02159 | Date 03/06/2019 |
| Token No | SM/18-19/3929 03/06/2019 | Serial | 018 |
| Patient Name | Mr. RAMKRISHNA RAM | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 54 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||