Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01811 | Date 19/03/2019 |
| Token No | SM/18-19/2883 19/03/2019 | Serial | 017 |
| Patient Name | Mr. KRISHNA KISHOR DEY | Contact No | 8820673597 |
| Address | 86C/A DEY ST | Age | 37 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||