Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02487 | Date 18/07/2019 |
| Token No | SM/18-19/4827 18/07/2019 | Serial | 005 |
| Patient Name | Mr. NIRANJAN SHA | Contact No | 7686909579 |
| Address | 3 DOSTI LANE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||