Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03293 | Date 24/10/2019 |
| Token No | SM/18-19/7163 24/10/2019 | Serial | 023 |
| Patient Name | Mr. RAJESH KUMAR SHA | Contact No | 9062375128 |
| Address | 30 DR NANILAL BHATTCHARYA | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||