Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00001 | Date 01/08/2018 |
| Token No | SM/18-19/4925 22/07/2019 | Serial | 018 |
| Patient Name | Mr. ASHOK DAS | Contact No | 9830908100 |
| Address | MANIKATALA | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||