Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02169 | Date 03/06/2019 |
| Token No | SM/18-19/3941 03/06/2019 | Serial | 030 |
| Patient Name | Mr. GOBINDO KUMAR VERMA | Contact No | 8777851230 |
| Address | B L C M BYE LANE | Age | 49 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||