Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02786 | Date 13/08/2019 |
| Token No | SM/18-19/5579 13/08/2019 | Serial | 004 |
| Patient Name | Mr. BIJAY KUMAR PRASAD | Contact No | 8013155733 |
| Address | 13 DEY STREET | Age | 33 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||