Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01650 | Date 12/02/2019 |
| Token No | SM/18-19/2428 12/02/2019 | Serial | 024 |
| Patient Name | Mr. DIPAK KR SHAW | Contact No | 8229990836 |
| Address | INDIAN JUTE MILL | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||