Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01360 | Date 11/12/2018 |
| Token No | SM/18-19/1932 11/12/2018 | Serial | 020 |
| Patient Name | Mr. RAJKUMAR BANERJEE | Contact No | 9903978748 |
| Address | 45A THAKURBATI BYE LANE | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||