Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03230 | Date 18/10/2019 |
| Token No | SM/18-19/7277 05/11/2019 | Serial | 029 |
| Patient Name | Mr. KAILASH DAS | Contact No | 9804890802 |
| Address | 124/1 MANIKTALA | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||