Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02682 | Date 01/08/2019 |
| Token No | SM/18-19/5323 01/08/2019 | Serial | 014 |
| Patient Name | Mr. ARJUN BARIK | Contact No | 6290867141 |
| Address | INDIA JUTE MILL | Age | 74 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||