Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02592 | Date 24/07/2019 |
| Token No | SM/18-19/5083 24/07/2019 | Serial | 006 |
| Patient Name | Mr. RAMSIYA MAHATO | Contact No | 9831083278 |
| Address | DEY GHAT LANE | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||