Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02800 | Date 13/08/2019 |
| Token No | SM/18-19/5601 13/08/2019 | Serial | 026 |
| Patient Name | Mr. BITTU ROY | Contact No | 8478004074 |
| Address | 56 AKHRA BATI | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||