Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03202 | Date 17/10/2019 |
| Token No | SM/18-19/6951 17/10/2019 | Serial | 012 |
| Patient Name | Mr. SUNIL HARIJAN | Contact No | 8583898791 |
| Address | 28 JANNAGAR ROAD | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||