Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02402 | Date 02/07/2019 |
| Token No | SM/18-19/4588 02/07/2019 | Serial | 018 |
| Patient Name | Mr. MANOJ POLAI | Contact No | 7450058539 |
| Address | 7/361 COCKRAIN ROAD | Age | 21 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||