Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02311 | Date 18/06/2019 |
| Token No | SM/18-19/4281 18/06/2019 | Serial | 035 |
| Patient Name | Mr. GANESH KR KHATIK | Contact No | 8820834468 |
| Address | DEY ST | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||