Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02771 | Date 08/08/2019 |
| Token No | SM/18-19/5531 08/08/2019 | Serial | 018 |
| Patient Name | Mr. SUMAN MONDOL | Contact No | 7548923863 |
| Address | 8B/1 DEY STREET | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||