Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02536 | Date 22/07/2019 |
| Token No | SM/18-19/4937 22/07/2019 | Serial | 030 |
| Patient Name | Mr. AMBIKA PATTANABISH | Contact No | NOT GIVEN |
| Address | B.L.C BYE LANE | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||