Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00255 | Date 24/08/2018 |
| Token No | SM/19-20/7908 06/12/2019 | Serial | 022 |
| Patient Name | Mr. ARUNJOY DEY | Contact No | 8240979927 |
| Address | A.K.C BHATTACHARYA STREET | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||