Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02557 | Date 20/07/2019 |
| Token No | SM/18-19/4991 20/07/2019 | Serial | 001 |
| Patient Name | Mr. AMIT DAS | Contact No | 9852586589 |
| Address | 11 B L C LANE | Age | 36 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||