Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01014 | Date 28/09/2018 |
| Token No | SM/18-19/1318 28/09/2018 | Serial | 008 |
| Patient Name | Mr. PRASANTA BOSE | Contact No | 8617279715 |
| Address | 14 K.C LANE | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||