Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02952 | Date 30/08/2019 |
| Token No | SM/18-19/6080 30/08/2019 | Serial | 063 |
| Patient Name | Mr. DURGA DAS | Contact No | 8900586950 |
| Address | PRAVAS NAGAR | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||