Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01927 | Date 16/04/2019 |
| Token No | SM/18-19/3251 16/04/2019 | Serial | 020 |
| Patient Name | Mr. PRASANTA DAS | Contact No | 9051682968 |
| Address | 57/21 RAILAND ROAD | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||