Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02082 | Date 17/05/2019 |
| Token No | SM/18-19/3865 30/05/2019 | Serial | 014 |
| Patient Name | Mr. ARJUN DAS | Contact No | 9830706830 |
| Address | 120 POTUA PARA LANE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||