Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01130 | Date 11/10/2018 |
| Token No | SM/18-19/2589 26/02/2019 | Serial | 001 |
| Patient Name | Mr. TARUN KUMAR SETH | Contact No | 9433641551 |
| Address | 10 CHATTERJEE LANE | Age | 64 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||