Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02175 | Date 04/06/2019 |
| Token No | SM/18-19/3956 04/06/2019 | Serial | 011 |
| Patient Name | Mr. TANUMAY DEY | Contact No | 9163035703 |
| Address | 31 AKHRABATI LANE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||