Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01586 | Date 17/01/2019 |
| Token No | SM/18-19/2294 17/01/2019 | Serial | 009 |
| Patient Name | Mr. SUSHANTA BISWAL | Contact No | 8420169861 |
| Address | 45 N L BHATTACHARJEE | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||