Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02567 | Date 20/07/2019 |
| Token No | SM/18-19/5020 20/07/2019 | Serial | 030 |
| Patient Name | Mr. PRADIP KOLEY | Contact No | 9654874596 |
| Address | BANERJEE PARA | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||