Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03084 | Date 19/09/2019 |
| Token No | SM/19-20/8327 10/01/2020 | Serial | 005 |
| Patient Name | Mr. LOKENATH GIRI | Contact No | 9903535985 |
| Address | 90C DEY STREET | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||