Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02332 | Date 21/06/2019 |
| Token No | SM/18-19/4478 27/06/2019 | Serial | 011 |
| Patient Name | Mr. HARI KRISHNA PRADHAN | Contact No | 9515024708 |
| Address | INDIA JUTE MILL | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||