Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00007 | Date 02/08/2018 |
| Token No | SM/18-19/4167 14/06/2019 | Serial | 025 |
| Patient Name | Mr. PRAKASH CHANDRA GUPTA | Contact No | 7890265309 |
| Address | DEY STREET | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||