Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02385 | Date 01/07/2019 |
| Token No | SM/18-19/4545 01/07/2019 | Serial | 008 |
| Patient Name | Mr. MANTU ROY | Contact No | NOT GIVEN |
| Address | RUDRA RAM PANDIT LANE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||