Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03553 | Date 05/12/2019 |
| Token No | SM/19-20/7874 05/12/2019 | Serial | 024 |
| Patient Name | Mr. SK NASIM | Contact No | 9163107648 |
| Address | SHEORAFULI | Age | 32 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||