Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01277 | Date 02/11/2018 |
| Token No | SM/18-19/1759 02/11/2018 | Serial | 011 |
| Patient Name | Mr. SANJOY SHAW | Contact No | 7605808134 |
| Address | 10 DEY STREET | Age | 26 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||