Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02134 | Date 28/05/2019 |
| Token No | SM/18-19/4742 11/07/2019 | Serial | 023 |
| Patient Name | Mr. UMA DEVI | Contact No | 8013111755 |
| Address | 79 DEY ST | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||