Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02088 | Date 20/05/2019 |
| Token No | SM/18-19/3735 20/05/2019 | Serial | 007 |
| Patient Name | Mr. BISWANATH ROY | Contact No | NOT GIVEN |
| Address | 7 AKHRA BATI LANE | Age | 51 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||