Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00967 | Date 25/09/2018 |
| Token No | SM/18-19/5877 26/08/2019 | Serial | 005 |
| Patient Name | Mr. PRANAB DEY | Contact No | 8478914125 |
| Address | 4 CHOWDHURI [PARA LANE | Age | 78 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||