Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00093 | Date 06/08/2018 |
| Token No | SM/18-19/1652 30/10/2018 | Serial | 004 |
| Patient Name | Mr. MITHULAL RAJBHAR | Contact No | NOT GIVEN |
| Address | CHATTERJEE LANE | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||