Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01668 | Date 14/02/2019 |
| Token No | SM/18-19/2462 14/02/2019 | Serial | 028 |
| Patient Name | Mr. KALU DEBNATH | Contact No | NOT GIVEN |
| Address | JOLKOL WORKER | Age | 49 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||