Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02016 | Date 02/05/2019 |
| Token No | SM/18-19/5988 28/08/2019 | Serial | 008 |
| Patient Name | Mr. KISHORE KUMAR RAM | Contact No | NOT GIVEN |
| Address | 2 NO GOPAL GANGULY LANE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||