Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02055 | Date 13/05/2019 |
| Token No | SM/18-19/5419 05/08/2019 | Serial | 023 |
| Patient Name | Mr. SUKUMAR BAG | Contact No | 9163552914 |
| Address | CHOWDHURY PARA LANE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||