Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03177 | Date 14/10/2019 |
| Token No | SM/18-19/6891 14/10/2019 | Serial | 007 |
| Patient Name | Mr. NARAYAN RAM | Contact No | 9477416601 |
| Address | 2 GOPLA GANGULY LANE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||