Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02579 | Date 01/07/2019 |
| Token No | SM/18-19/5032 01/07/2019 | Serial | 006 |
| Patient Name | Mr. MD ANWAR | Contact No | 7925869878 |
| Address | LAL MOHON GOSWAMI LANE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||