Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02763 | Date 07/08/2019 |
| Token No | SM/18-19/5507 07/08/2019 | Serial | 023 |
| Patient Name | Mr. SUKHDEB RAM | Contact No | 9830450926 |
| Address | 9/A KALINATH BHATTACHARYA STREET | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||