Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01917 | Date 11/04/2019 |
| Token No | SM/18-19/3196 11/04/2019 | Serial | 018 |
| Patient Name | Mr. SIBAPRASAD DAS | Contact No | 9432161591 |
| Address | 73/33 J.N LAHIRI ROAD | Age | 68 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||