Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01141 | Date 12/10/2018 |
| Token No | SM/18-19/1535 12/10/2018 | Serial | 008 |
| Patient Name | Mr. SUMON CHATTERJEE | Contact No | 8777630075 |
| Address | 107/B NEHERU NAGAR COLONY | Age | 34 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||