Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02681 | Date 01/08/2019 |
| Token No | SM/18-19/5321 01/08/2019 | Serial | 012 |
| Patient Name | Mr. RANJIT KUMAR DUTTA | Contact No | 9477514442 |
| Address | 54 KALITALA | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||