Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02239 | Date 11/06/2019 |
| Token No | SM/18-19/4602 05/07/2019 | Serial | 010 |
| Patient Name | Mr. JOY DEB KOIRI | Contact No | 8961451363 |
| Address | 5 A.K.C BHATTACHARYA ST | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||