Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02815 | Date 16/08/2019 |
| Token No | SM/18-19/6072 30/08/2019 | Serial | 055 |
| Patient Name | Mr. SUNITI DEY | Contact No | 8017284391 |
| Address | 4D DEY STREET | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||