Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03198 | Date 17/10/2019 |
| Token No | SM/18-19/6944 17/10/2019 | Serial | 005 |
| Patient Name | Mr. SISIR LAL SAMADDAR | Contact No | 9433382420 |
| Address | NAGA BAZAR , 275/1 G T ROAD | Age | 72 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||