Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02545 | Date 22/07/2019 |
| Token No | SM/18-19/4958 22/07/2019 | Serial | 051 |
| Patient Name | Mr. NARAYAN DAS | Contact No | NOT GIVEN |
| Address | 2 NO RAJYADHAR PUR | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||