Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03754 | Date 22/01/2020 |
| Token No | SM/19-20/8450 22/01/2020 | Serial | 004 |
| Patient Name | Mr. TAPAN KUMAR DAS | Contact No | 7059677289 |
| Address | 3/C BAISHNAB PARA 2ND LANE | Age | 72 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||