Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02313 | Date 18/06/2019 |
| Token No | SM/19-20/7942 09/12/2019 | Serial | 015 |
| Patient Name | Mr. CHANDRANATH DEY | Contact No | 9831880838 |
| Address | 4 DEY STREET | Age | 64 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||