Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03295 | Date 25/10/2019 |
| Token No | SM/19-20/7975 09/12/2019 | Serial | 048 |
| Patient Name | Mr. NIMAI PAL | Contact No | 9748231069 |
| Address | 9 NO INDIA JUTE MILL | Age | 49 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||