Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02457 | Date 11/07/2019 |
| Token No | SM/18-19/4721 11/07/2019 | Serial | 002 |
| Patient Name | Mr. NABA KUMAR DEY | Contact No | 8981257648 |
| Address | 26 THAKUR BATI STREET | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||