Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01563 | Date 10/01/2019 |
| Token No | SM/18-19/2248 10/01/2019 | Serial | 010 |
| Patient Name | Mr. NIMAI CHANDRA DEY | Contact No | NOT GIVEN |
| Address | CHOWDHURI PARA LANE | Age | 77 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||