Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 02663 | Date 30/07/2019 |
| Token No | SM/18-19/5503 07/08/2019 | Serial | 019 |
| Patient Name | Mr. LALU DEBNATH | Contact No | NOT GIVEN |
| Address | MAHES KOLONY | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||