Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02958 | Date 01/09/2019 |
| Token No | SM/18-19/6112 01/09/2019 | Serial | 004 |
| Patient Name | Mr. RATAN KUMAR PATWA | Contact No | 9038696522 |
| Address | 30 K M BHATTACHARYA STREET | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||