Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03405 | Date 16/11/2019 |
| Token No | SM/18-19/7456 16/11/2019 | Serial | 006 |
| Patient Name | Mr. KARTIK PRAMANIK | Contact No | 9339577721 |
| Address | 68 PATUA PARA | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||