Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01805 | Date 13/03/2019 |
| Token No | SM/18-19/2842 13/03/2019 | Serial | 032 |
| Patient Name | Mr. SASTHI DUTTA | Contact No | NOT GIVEN |
| Address | 36 DHULI PARA | Age | 62 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||