Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02471 | Date 15/07/2019 |
| Token No | SM/18-19/4766 15/07/2019 | Serial | 012 |
| Patient Name | Mr. SK IZAZ | Contact No | 9088025000 |
| Address | 15 ACHARYA K C BHATTACHARJEE STREET | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||