Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02692 | Date 01/08/2019 |
| Token No | SM/18-19/5337 01/08/2019 | Serial | 028 |
| Patient Name | Mr. RAJAT SUBHRA SINHA | Contact No | 8697612520 |
| Address | 18 PANCHANAN TALA LANE | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||