Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02719 | Date 05/08/2019 |
| Token No | SM/18-19/5409 05/08/2019 | Serial | 013 |
| Patient Name | Mr. SK SUJAT | Contact No | 9007842135 |
| Address | 21a akc bhattacharya street | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||