Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02089 | Date 20/05/2019 |
| Token No | SM/18-19/6670 24/09/2019 | Serial | 025 |
| Patient Name | Mr. SANKAR RAM | Contact No | 7998083904 |
| Address | 2 GOPAL GANGULY LANE | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||