Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02340 | Date 24/06/2019 |
| Token No | SM/19-20/8910 24/09/2020 | Serial | 003 |
| Patient Name | Mr. SANTOSH KUMAR DAS | Contact No | 9804671656 |
| Address | THAKUR BATI STREET | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||