Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03071 | Date 19/09/2019 |
| Token No | SM/18-19/6545 19/09/2019 | Serial | 005 |
| Patient Name | Mr. SAMIR NEOGI | Contact No | 9432224683 |
| Address | 33A/2 CHANDRA MOHON ROY LANE | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||