Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02493 | Date 18/07/2019 |
| Token No | SM/18-19/7030 19/10/2019 | Serial | 003 |
| Patient Name | Mr. ACHINTYA KUMAR MANNA | Contact No | 9475719573 |
| Address | 32B CHOWDHURY PARA LANE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||