Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02571 | Date 20/07/2019 |
| Token No | SM/18-19/5024 20/07/2019 | Serial | 034 |
| Patient Name | Mr. NANI GOPAL SAHA | Contact No | 8001458690 |
| Address | BECHU DEY LANE | Age | 62 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||