Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01712 | Date 22/02/2019 |
| Token No | SM/18-19/2577 22/02/2019 | Serial | 020 |
| Patient Name | Mr. PRITAM KR DEY | Contact No | 9804028776 |
| Address | DEY ST | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||