Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00169 | Date 16/09/2019 |
| Token No | SM/19-20/261 20/09/2019 | Serial | 024 |
| Patient Name | Mr. SUFAL BARIK | Contact No | 8348220398 |
| Address | SAT GACHI GUPTI PARA | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||