Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01783 | Date 12/03/2019 |
| Token No | SM/18-19/5398 05/08/2019 | Serial | 002 |
| Patient Name | Mr. MADAN DUTTA | Contact No | 9830522953 |
| Address | 54 G.T. ROAD | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||