Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 00086 | Date 12/09/2019 |
| Token No | SM/19-20/1322 31/12/2019 | Serial | 005 |
| Patient Name | Mr. BHASKAR PAL | Contact No | 9681050380 |
| Address | GURU GARDEN,SHEORAPHULLY | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||