Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01684 | Date 15/02/2019 |
| Token No | SM/18-19/2495 15/02/2019 | Serial | 024 |
| Patient Name | Mr. AMARNATH BANERJEE | Contact No | NOT GIVEN |
| Address | 17D BHAGIRATHI LANE | Age | 60 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||