Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03446 | Date 21/11/2019 |
| Token No | SM/19-20/7699 28/11/2019 | Serial | 001 |
| Patient Name | Mr. PRASANTA KUMAR JENA | Contact No | 8961139431 |
| Address | 9 NO LINE INDIA JUTE MILL | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||