Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03345 | Date 11/11/2019 |
| Token No | SM/18-19/7320 11/11/2019 | Serial | 004 |
| Patient Name | Mr. RAHUL MAITY | Contact No | 9330483416 |
| Address | MANIK TALA | Age | 26 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||