Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02621 | Date 26/07/2019 |
| Token No | SM/18-19/5131 26/07/2019 | Serial | 010 |
| Patient Name | Mr. ALOK KUMAR GHOSAL | Contact No | 9675862589 |
| Address | KALITALA | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||