Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02652 | Date 29/07/2019 |
| Token No | SM/18-19/5233 29/07/2019 | Serial | 043 |
| Patient Name | Mr. CHANDAN PRADHAN | Contact No | 9002695176 |
| Address | 86NO DEY STREER | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||