Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01759 | Date 07/03/2019 |
| Token No | SM/18-19/2702 07/03/2019 | Serial | 014 |
| Patient Name | Mr. SANJAY MITRA | Contact No | 7044521830 |
| Address | 14 PANCHANAN TALA LANE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||