Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02104 | Date 23/05/2019 |
| Token No | SM/18-19/3768 23/05/2019 | Serial | 002 |
| Patient Name | Mr. KUNAL DEY | Contact No | 8276809860 |
| Address | 27 JANNAGAR ROAD | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||