Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01662 | Date 14/02/2019 |
| Token No | SM/18-19/2551 21/02/2019 | Serial | 019 |
| Patient Name | Master BUNTY DEBNATH | Contact No | 9903142444 |
| Address | BIBIR BEL KOURIR BAGAN, SERAMPORE | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||