Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03236 | Date 19/10/2019 |
| Token No | SM/18-19/7032 19/10/2019 | Serial | 005 |
| Patient Name | Mr. NIMAI SHRIMANI | Contact No | NOT GIVEN |
| Address | 25A DEY ST | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||