Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01658 | Date 14/02/2019 |
| Token No | SM/18-19/5344 02/08/2019 | Serial | 004 |
| Patient Name | Mr. SAJAL NANDI | Contact No | 8420456425 |
| Address | 27 CHOWDHURY PARA | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||