Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03196 | Date 15/10/2019 |
| Token No | SM/18-19/6935 15/10/2019 | Serial | 027 |
| Patient Name | Mr. SUBHASH BARAD | Contact No | 9088494430 |
| Address | 12 DHARMATALA | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||