Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02789 | Date 13/08/2019 |
| Token No | SM/18-19/5587 13/08/2019 | Serial | 012 |
| Patient Name | Mr. JAYANTA DAS | Contact No | 7006589598 |
| Address | KHATIR BAZAR | Age | 30 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||