Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03479 | Date 26/11/2019 |
| Token No | SM/19-20/7676 26/11/2019 | Serial | 005 |
| Patient Name | Mr. MADHUSUDAN BISWAL | Contact No | 6291333464 |
| Address | 10 KALIDAS BHATTACHARYA LANE | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||