Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02733 | Date 06/08/2019 |
| Token No | SM/18-19/5773 20/08/2019 | Serial | 041 |
| Patient Name | Mr. LAL BABU PRASAD | Contact No | 9432444371 |
| Address | 52/A DR NONILAL BHATTACHARYA STREET | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||