Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03193 | Date 15/10/2019 |
| Token No | SM/18-19/6928 15/10/2019 | Serial | 020 |
| Patient Name | Mr. RAMESH PAL | Contact No | 9007752705 |
| Address | 11/318 JUTE MILL | Age | 31 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||