Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03663 | Date 03/01/2020 |
| Token No | SM/19-20/8214 03/01/2020 | Serial | 012 |
| Patient Name | Mr. MANISHANKAR PAL | Contact No | 9433667840 |
| Address | JAGANNATH GHAT LANE | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||