Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02563 | Date 20/07/2019 |
| Token No | SM/18-19/5013 20/07/2019 | Serial | 023 |
| Patient Name | Mr. DIPANJAN DAS | Contact No | 9878457879 |
| Address | 12 PANCHANAN TALA LANE | Age | 26 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||