Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02852 | Date 20/08/2019 |
| Token No | SM/18-19/6166 03/09/2019 | Serial | 013 |
| Patient Name | Mr. RAJESH RAJBHAR | Contact No | 9432013828 |
| Address | 10 NO DEY STREET | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||