Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02419 | Date 05/07/2019 |
| Token No | SM/18-19/4758 15/07/2019 | Serial | 004 |
| Patient Name | Mr. BINOD KUMAR DAS | Contact No | 8013891031 |
| Address | RUDRA RAM PANDIT LANE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||