Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03243 | Date 21/10/2019 |
| Token No | SM/18-19/7053 21/10/2019 | Serial | 020 |
| Patient Name | Mr. FULCHAND SK | Contact No | 6290416117 |
| Address | DEY STREET | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||