Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03670 | Date 03/01/2020 |
| Token No | SM/19-20/8223 03/01/2020 | Serial | 021 |
| Patient Name | Mr. BIMAL PUROKAYAT | Contact No | 9434859058 |
| Address | KALITALA | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||