Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00732 | Date 18/09/2018 |
| Token No | SM/18-19/983 18/09/2018 | Serial | 010 |
| Patient Name | Mr. PURNA CHANDRA BISWAL | Contact No | 7003521703 |
| Address | CHOWDHURY PARA | Age | 42 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||