Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02459 | Date 11/07/2019 |
| Token No | SM/18-19/4724 11/07/2019 | Serial | 005 |
| Patient Name | Mr. CHANDRIKA PANDIT | Contact No | NOT GIVEN |
| Address | DEY BAGAN, MANIKTALA | Age | 60 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||