Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01041 | Date 04/10/2018 |
| Token No | SM/18-19/1872 04/12/2018 | Serial | 008 |
| Patient Name | Mr. SUJOY DEY | Contact No | 9830039498 |
| Address | 90C/6 DEY STREET | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||