Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00983 | Date 27/09/2018 |
| Token No | SM/19-20/8210 03/01/2020 | Serial | 008 |
| Patient Name | Mr. BIMAL BISWAL | Contact No | 9330388521 |
| Address | 44/B N.L BHATTACHARYA STREET | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||