Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02653 | Date 29/07/2019 |
| Token No | SM/18-19/5235 29/07/2019 | Serial | 045 |
| Patient Name | Mr. KALI SANKAR MONDAL | Contact No | 9038103895 |
| Address | MALLICK PARA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||