Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02220 | Date 10/06/2019 |
| Token No | SM/18-19/4059 10/06/2019 | Serial | 027 |
| Patient Name | Mr. NANDA KISHOR SHA | Contact No | 9748863894 |
| Address | 10 NO LINE | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||