Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03671 | Date 03/01/2020 |
| Token No | SM/19-20/8224 03/01/2020 | Serial | 022 |
| Patient Name | Mr. BUBAI DE | Contact No | 7006988520 |
| Address | BAT TALA MORER MATHA | Age | 29 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||