Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03064 | Date 17/09/2019 |
| Token No | SM/18-19/6506 17/09/2019 | Serial | 006 |
| Patient Name | Mr. JITENDAR APAT | Contact No | 9007591910 |
| Address | 2A ACHARYA BHATTACHARYA STREET | Age | 38 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||