Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03058 | Date 16/09/2019 |
| Token No | SM/18-19/7118 22/10/2019 | Serial | 033 |
| Patient Name | Mr. RAM KUMAR | Contact No | 9199010670 |
| Address | JOLKOL WORKER | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||