Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02596 | Date 24/07/2019 |
| Token No | SM/18-19/7229 01/11/2019 | Serial | 011 |
| Patient Name | Mr. SUBODH KUMAR SINHA RAY | Contact No | 26626850 |
| Address | 88B/1 DEY STREET | Age | 70 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||