Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03025 | Date 12/09/2019 |
| Token No | SM/18-19/6355 12/09/2019 | Serial | 002 |
| Patient Name | Mr. NABA KUMATR KINDU | Contact No | 8617745626 |
| Address | 35 A K C BHATTACHARYA STREET | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||