Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01724 | Date 28/02/2019 |
| Token No | SM/18-19/2625 28/02/2019 | Serial | 009 |
| Patient Name | Mr. BIJAY RAM | Contact No | 9038704364 |
| Address | 17/1/12 CHOWDHURY PARA LANE | Age | 39 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||