Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02171 | Date 04/06/2019 |
| Token No | SM/18-19/3947 04/06/2019 | Serial | 002 |
| Patient Name | Mr. SRI CHAND RAM | Contact No | 7003674235 |
| Address | 2 GOPAL GANGULY LANE | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||