Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02721 | Date 05/08/2019 |
| Token No | SM/18-19/5412 05/08/2019 | Serial | 016 |
| Patient Name | Mr. SANJAY MITRA | Contact No | 9163101934 |
| Address | 14 PANCHANAN TALA LANE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||