Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01954 | Date 22/04/2019 |
| Token No | SM/18-19/3673 16/05/2019 | Serial | 013 |
| Patient Name | Mr. SK SARUK | Contact No | 8820074455 |
| Address | 13 AKC BHATTACHARYA ST | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||