Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02291 | Date 17/06/2019 |
| Token No | SM/18-19/7587 21/11/2019 | Serial | 008 |
| Patient Name | Mr. UMA SHANKAR | Contact No | 9062253286 |
| Address | 9/467 INDIA JUTE MILL | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||