Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02919 | Date 28/08/2019 |
| Token No | SM/19-20/7768 29/11/2019 | Serial | 031 |
| Patient Name | Mr. SK. BINOD | Contact No | 8017727336 |
| Address | DR. MB STREET | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||