Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02969 | Date 02/09/2019 |
| Token No | SM/18-19/6145 02/09/2019 | Serial | 003 |
| Patient Name | Mr. GANESH ROY | Contact No | 9330598093 |
| Address | RAM SITA BAGAN | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||