Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00634 | Date 07/09/2018 |
| Token No | SM/18-19/2748 08/03/2019 | Serial | 026 |
| Patient Name | Mr. BINOD DAS | Contact No | 8981218370 |
| Address | 573 G.T ROAD, MANIKTALA | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||