Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02262 | Date 14/06/2019 |
| Token No | SM/19-20/8042 13/12/2019 | Serial | 015 |
| Patient Name | Mr. AMIT KUMAR SHA | Contact No | 9062375128 |
| Address | 30 NANILAL BHATTACHARYA STREET | Age | 23 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||