Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02297 | Date 18/06/2019 |
| Token No | SM/18-19/4257 18/06/2019 | Serial | 011 |
| Patient Name | Mr. AVIJIT DEY | Contact No | NOT GIVEN |
| Address | 19B A.B.GARDEN LANE | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||