Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01537 | Date 03/01/2019 |
| Token No | SM/18-19/2180 03/01/2019 | Serial | 001 |
| Patient Name | Mr. AMAR DAS | Contact No | NOT GIVEN |
| Address | 111 G T ROAD, MANIKTALA | Age | 85 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||