Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02510 | Date 19/07/2019 |
| Token No | SM/18-19/5110 25/07/2019 | Serial | 015 |
| Patient Name | Mr. DEBABRATA RANA | Contact No | 9474573141 |
| Address | 5 RUDRA RAM PANDIT LANE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||