Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02562 | Date 20/07/2019 |
| Token No | SM/18-19/5012 20/07/2019 | Serial | 022 |
| Patient Name | Mr. SK RAMJAN | Contact No | 9830058890 |
| Address | 12 K C BHATTACHARYA STREET | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||