Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03472 | Date 22/11/2019 |
| Token No | SM/18-19/7663 22/11/2019 | Serial | 022 |
| Patient Name | Mr. MANOJ DAS | Contact No | NOT GIVEN |
| Address | JOLKOL WORKER | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||