Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03083 | Date 19/09/2019 |
| Token No | SM/18-19/6577 19/09/2019 | Serial | 037 |
| Patient Name | Mr. BIJOY RAO | Contact No | 8017522209 |
| Address | 7 DEY GHAT LANE | Age | 23 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||