Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02570 | Date 20/07/2019 |
| Token No | SM/18-19/5023 20/07/2019 | Serial | 033 |
| Patient Name | Mr. ARITRO ROY | Contact No | 8100058968 |
| Address | 54 DEY STREET | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||