Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03470 | Date 22/11/2019 |
| Token No | SM/18-19/7659 22/11/2019 | Serial | 018 |
| Patient Name | Mr. RADHAKRISHNA BISWAL | Contact No | NOT GIVEN |
| Address | 52 N L BHATTACHARJEE STREET | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||