Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02809 | Date 16/08/2019 |
| Token No | SM/18-19/5996 28/08/2019 | Serial | 016 |
| Patient Name | Mr. BAIJNATH RAY | Contact No | 8479848850 |
| Address | 11 RAM SITA LANE | Age | 75 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||