Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02895 | Date 26/08/2019 |
| Token No | SM/18-19/5916 26/08/2019 | Serial | 044 |
| Patient Name | Mr. SHYAMAL DEY | Contact No | 9433216189 |
| Address | 20 NO TS LANE | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||