Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04011 | Date 24/08/2020 |
| Token No | SM/19-20/8843 24/08/2020 | Serial | 002 |
| Patient Name | Mr. AMIT DAS | Contact No | 9874587890 |
| Address | JAGANNATH GHAT LANE | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||