Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04029 | Date 21/09/2020 |
| Token No | SM/19-20/8885 21/09/2020 | Serial | 005 |
| Patient Name | Mr. HARAPRASAD DAS | Contact No | 9836287642 |
| Address | 538 G T ROAD | Age | 67 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||