Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03043 | Date 14/09/2019 |
| Token No | SM/18-19/6440 14/09/2019 | Serial | 004 |
| Patient Name | Mr. SOURAV PARIDA | Contact No | 7044696080 |
| Address | DEY BARI | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||