Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03351 | Date 11/11/2019 |
| Token No | SM/18-19/7340 11/11/2019 | Serial | 024 |
| Patient Name | Mr. AKASH RAY | Contact No | 8420758528 |
| Address | 86/C/6 DEY ST | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||