Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01604 | Date 22/01/2019 |
| Token No | SM/18-19/4846 18/07/2019 | Serial | 024 |
| Patient Name | Mr. RAJ KUMAR DAS | Contact No | 9331623210 |
| Address | 68 PATUA [PARA LANE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||