Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02580 | Date 01/07/2019 |
| Token No | SM/18-19/5033 01/07/2019 | Serial | 007 |
| Patient Name | Mr. RAKESH PRASAD | Contact No | |
| Address | MANIK TALA | Age | 58 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||