Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01286 | Date 16/11/2018 |
| Token No | SM/18-19/1775 16/11/2018 | Serial | 008 |
| Patient Name | Mr. SUDIP KUNDU | Contact No | 6290813245 |
| Address | 37 B A.K.C BHATTACHARYA ST | Age | 44 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||