Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02070 | Date 16/05/2019 |
| Token No | SM/18-19/3678 16/05/2019 | Serial | 018 |
| Patient Name | Mr. AMAR KUMAR DAS | Contact No | 9038198349 |
| Address | 47/1 N.L. BHATTACHARYA ST | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||