Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01614 | Date 01/02/2019 |
| Token No | SM/18-19/2340 01/02/2019 | Serial | 012 |
| Patient Name | Mr. NILMONI HAZRA | Contact No | 8017570186 |
| Address | CHATRA | Age | 48 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||