Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03490 | Date 28/11/2019 |
| Token No | SM/19-20/7721 28/11/2019 | Serial | 023 |
| Patient Name | Mr. BABU RAM HELA | Contact No | 9831370668 |
| Address | 12 NO LINE RAM SITA LINE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||