Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02505 | Date 18/07/2019 |
| Token No | SM/18-19/4858 18/07/2019 | Serial | 036 |
| Patient Name | Mr. SUDAMA PAL | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 35 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||