Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03300 | Date 25/10/2019 |
| Token No | SM/18-19/7183 25/10/2019 | Serial | 019 |
| Patient Name | Mr. UJJAL MANJHI | Contact No | NOT GIVEN |
| Address | 28 BARAL BAGAN | Age | 38 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||