Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03212 | Date 18/10/2019 |
| Token No | SM/18-19/6976 18/10/2019 | Serial | 001 |
| Patient Name | Mr. SONU KUMAR MANJHI | Contact No | 9608377834 |
| Address | DEY STREET | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||