Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02657 | Date 30/07/2019 |
| Token No | SM/18-19/5248 30/07/2019 | Serial | 013 |
| Patient Name | Mr. KAMAL DEV ROY | Contact No | 8276066461 |
| Address | DEY STREET | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||