Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03120 | Date 25/09/2019 |
| Token No | SM/18-19/6688 25/09/2019 | Serial | 006 |
| Patient Name | Mr. CHINMOY DEY | Contact No | 7003508954 |
| Address | 4 CHOWDHURY PARA | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||