Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01664 | Date 14/02/2019 |
| Token No | SM/18-19/2659 01/03/2019 | Serial | 018 |
| Patient Name | Mr. DULAL KUNDU | Contact No | 7044096209 |
| Address | A.K.C BHATTACHARYA ST | Age | 85 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||