Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02421 | Date 08/07/2019 |
| Token No | SM/18-19/4774 15/07/2019 | Serial | 020 |
| Patient Name | Mr. ARUN DAS | Contact No | 8961663664 |
| Address | 15/A/1 PATUA PARA LANE | Age | 72 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||