Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03305 | Date 31/10/2019 |
| Token No | SM/18-19/7196 31/10/2019 | Serial | 013 |
| Patient Name | Mr. SURENDRA NAYAK | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||