Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01958 | Date 23/04/2019 |
| Token No | SM/18-19/7263 05/11/2019 | Serial | 015 |
| Patient Name | Mr. MRITYUNJOY DEY | Contact No | 9432454167 |
| Address | 5C/1 DEY ST | Age | 73 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||