Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02221 | Date 10/06/2019 |
| Token No | SM/18-19/5361 02/08/2019 | Serial | 021 |
| Patient Name | Mr. PABAN KUMAR SINGH | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||