Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03010 | Date 06/09/2019 |
| Token No | SM/18-19/6301 06/09/2019 | Serial | 049 |
| Patient Name | Mr. MANTU DAS | Contact No | 9163773722 |
| Address | 52 DEY STREET | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||