Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02451 | Date 09/07/2019 |
| Token No | SM/18-19/4703 09/07/2019 | Serial | 019 |
| Patient Name | Mr. SK SADDAM | Contact No | NOT GIVEN |
| Address | 23 A K C BHATTACHARYA STREET | Age | 17 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||