Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03710 | Date 07/01/2020 |
| Token No | SM/19-20/8300 07/01/2020 | Serial | 031 |
| Patient Name | Mr. DILIP KUMAR SHAW | Contact No | 9874440016 |
| Address | 14 ACHARYA K C BHATTACHARYE STREET | Age | 34 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 79 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||