Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03162 | Date 01/10/2019 |
| Token No | SM/18-19/6852 01/10/2019 | Serial | 042 |
| Patient Name | Mr. MURARI MOHAN DAS | Contact No | 8017058152 |
| Address | 90C/B DEY STREET | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||