Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02216 | Date 10/06/2019 |
| Token No | SM/18-19/4051 10/06/2019 | Serial | 019 |
| Patient Name | Mr. GORA CHAND KUNDU | Contact No | 9903789899 |
| Address | 86 DEY ST | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||