Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 02162 | Date 03/06/2019 |
| Token No | SM/18-19/4267 18/06/2019 | Serial | 021 |
| Patient Name | Mr. TAPAN DEY | Contact No | 9433897370 |
| Address | MAHESH COLONY | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||