Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01311 | Date 29/11/2018 |
| Token No | SM/18-19/1836 29/11/2018 | Serial | 004 |
| Patient Name | Mr. TAPAN MAJUMDER | Contact No | 8017797618 |
| Address | 16/I SATISH CH GHOSH LANE | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||