Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03319 | Date 01/11/2019 |
| Token No | SM/19-20/8466 24/01/2020 | Serial | 008 |
| Patient Name | Miss SONU BISWAL | Contact No | 9123997928 |
| Address | 45 NANILAL BHATTACHARYA STREET | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||