Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01893 | Date 08/04/2019 |
| Token No | SM/18-19/3191 11/04/2019 | Serial | 013 |
| Patient Name | Mr. DILIP KUMAR KUNDU | Contact No | 9433641551 |
| Address | 35 K C BHATTACHARJEE STREET | Age | 51 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||