Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02912 | Date 27/08/2019 |
| Token No | SM/18-19/6716 26/09/2019 | Serial | 027 |
| Patient Name | Mr. RAMESHWAR KOIRI | Contact No | 8820645711 |
| Address | 17 BARAL BAGAN | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||