Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00566 | Date 17/12/2019 |
| Token No | SM/19-20/1149 17/12/2019 | Serial | 018 |
| Patient Name | Mr. SAMAL BHUIYAN | Contact No | |
| Address | MINIUS QUARTER PRABASHNAGAR | Age | 34 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||