Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03003 | Date 06/09/2019 |
| Token No | SM/18-19/6268 06/09/2019 | Serial | 016 |
| Patient Name | Mr. MANOJ ROY | Contact No | 9903127113 |
| Address | 8/378 RAM SITA LANE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||