Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01742 | Date 05/03/2019 |
| Token No | SM/18-19/2719 07/03/2019 | Serial | 006 |
| Patient Name | Mr. BISWANATH DAS | Contact No | 8334949756 |
| Address | 12 DEY ST | Age | 70 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||