Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01955 | Date 22/04/2019 |
| Token No | SM/18-19/3322 22/04/2019 | Serial | 015 |
| Patient Name | Mr. ALOK RAXIT | Contact No | 9674453812 |
| Address | 47 LALIT MOHAN BHATTACHARYA ST | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||