Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02446 | Date 09/07/2019 |
| Token No | SM/18-19/4694 09/07/2019 | Serial | 010 |
| Patient Name | Mr. RAM YODHHA RAY | Contact No | 8479848850 |
| Address | RAM SITA LANE | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||