Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01639 | Date 08/02/2019 |
| Token No | SM/18-19/2402 08/02/2019 | Serial | 017 |
| Patient Name | Mr. MRITYUNJOY DEY | Contact No | 9432383398 |
| Address | 3 A K C BHATTACHARYA ST | Age | 79 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||