Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03275 | Date 22/10/2019 |
| Token No | SM/18-19/7205 31/10/2019 | Serial | 022 |
| Patient Name | Mr. AVI DAS | Contact No | 9874150857 |
| Address | 68/D/1 BAISHNAB PARA 2ND LANE | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||