Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00497 | Date 03/12/2019 |
| Token No | SM/19-20/953 03/12/2019 | Serial | 018 |
| Patient Name | Mr. GANI DAS | Contact No | 8697358402 |
| Address | D CRUZE GARDEN LANE PRABASHNAGAR | Age | 65 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||