Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03606 | Date 13/12/2019 |
| Token No | SM/19-20/8031 13/12/2019 | Serial | 004 |
| Patient Name | Mr. SUNIL DAS | Contact No | 7278830385 |
| Address | 5 AKHRA BATI LANE | Age | 38 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||