Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02720 | Date 05/08/2019 |
| Token No | SM/18-19/5411 05/08/2019 | Serial | 015 |
| Patient Name | Mr. SAILEN DEY | Contact No | 8981741097 |
| Address | 1 A B GARDEN LANE | Age | 63 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||