Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03041 | Date 14/09/2019 |
| Token No | SM/18-19/7097 22/10/2019 | Serial | 012 |
| Patient Name | Mr. SK TINKU | Contact No | NOT GIVEN |
| Address | TIN BAZAR BYE LANE | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||