Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03206 | Date 17/10/2019 |
| Token No | SM/18-19/6961 17/10/2019 | Serial | 022 |
| Patient Name | Mr. KRUSHNA BISWAL | Contact No | 9330032624 |
| Address | INDIA JUTE MILL, RAM SITA LINE | Age | 34 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||