Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02495 | Date 18/07/2019 |
| Token No | SM/18-19/4842 18/07/2019 | Serial | 020 |
| Patient Name | Mr. RAJ PRASAD SARAKAR | Contact No | 8478981317 |
| Address | 32/2 BHATTACHARYA GARDEN | Age | 52 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||