Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03258 | Date 22/10/2019 |
| Token No | SM/18-19/7087 22/10/2019 | Serial | 002 |
| Patient Name | Mr. RABINDRA NATH DEY | Contact No | 9007653493 |
| Address | 17D NOTUN BAGAN LANE | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||