Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03327 | Date 05/11/2019 |
| Token No | SM/18-19/7254 05/11/2019 | Serial | 006 |
| Patient Name | Mr. ASHOK DAS | Contact No | 9674193846 |
| Address | PATUA PARA | Age | 42 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||