Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03452 | Date 21/11/2019 |
| Token No | SM/18-19/7604 21/11/2019 | Serial | 025 |
| Patient Name | Mr. RAJU RAO | Contact No | NOT GIVEN |
| Address | SERAMPORE 58 NO LANE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||