Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00563 | Date 10/08/2018 |
| Token No | SM/18-19/3378 25/04/2019 | Serial | 010 |
| Patient Name | Mr. HARAPRASAD DEY | Contact No | 9477221327 |
| Address | 1 DEY ST | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||