Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02116 | Date 27/05/2019 |
| Token No | SM/18-19/4492 27/06/2019 | Serial | 025 |
| Patient Name | Mr. KARTIK CHANDRA DEY | Contact No | 9330012728 |
| Address | 75 DEY ST | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||