Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03986 | Date 14/07/2020 |
| Token No | SM/19-20/8813 14/07/2020 | Serial | 011 |
| Patient Name | Mr. AJAY BISWAS | Contact No | 8017057812 |
| Address | 116 NEHRU NAGAR COLONY | Age | 57 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||