Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01626 | Date 07/02/2019 |
| Token No | SM/18-19/2364 07/02/2019 | Serial | 005 |
| Patient Name | Mr. NIRMAL HALDER | Contact No | NOT GIVEN |
| Address | JAL KAL STAFF | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||