Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02572 | Date 01/07/2019 |
| Token No | SM/18-19/5025 01/07/2019 | Serial | 035 |
| Patient Name | Mr. AMAR MONDAL | Contact No | 9038801477 |
| Address | THAKUR NATI STREET | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||