Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01950 | Date 22/04/2019 |
| Token No | SM/18-19/3314 22/04/2019 | Serial | 007 |
| Patient Name | Mr. TAPAS CHAKRABORTY | Contact No | 9874670868 |
| Address | 3 KAILASH CHATTERJEE LANE | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||