Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01565 | Date 11/01/2019 |
| Token No | SM/18-19/2252 11/01/2019 | Serial | 004 |
| Patient Name | Mr. SOUREN KR BANERJEE | Contact No | 26529364 |
| Address | 5A PITAMBAR DEY LANE | Age | 76 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||