Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03494 | Date 28/11/2019 |
| Token No | SM/19-20/7737 28/11/2019 | Serial | 039 |
| Patient Name | Mr. KAJAL MONDOL | Contact No | NOT GIVEN |
| Address | JOLKOL WORKER | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||