Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 02559 | Date 20/07/2019 |
| Token No | SM/18-19/5009 20/07/2019 | Serial | 019 |
| Patient Name | Mr. RAMESH AGARWALA | Contact No | NOT GIVEN |
| Address | GANGULY BAGAN | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||