Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03387 | Date 15/11/2019 |
| Token No | SM/18-19/7596 21/11/2019 | Serial | 017 |
| Patient Name | Mr. SK RAMJAN | Contact No | 9903275143 |
| Address | 50 DR NANILAL BHATTCAHRYA STREET | Age | 60 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||