Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02689 | Date 01/08/2019 |
| Token No | SM/18-19/5333 01/08/2019 | Serial | 024 |
| Patient Name | Mr. MADHUSUDAN DEY | Contact No | 9433729402 |
| Address | 5 NO DEY STREET | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||