Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03116 | Date 24/09/2019 |
| Token No | SM/18-19/6681 24/09/2019 | Serial | 036 |
| Patient Name | Mr. RANJIT DAS | Contact No | 7890054102 |
| Address | 111 G.T.ROAD | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||