Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02204 | Date 07/06/2019 |
| Token No | SM/18-19/4012 07/06/2019 | Serial | 009 |
| Patient Name | Mr. RAM BABU ROY | Contact No | NOT GIVEN |
| Address | PACHUBABUR BAZAR | Age | 42 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||