Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01333 | Date 04/12/2018 |
| Token No | SM/18-19/3441 29/04/2019 | Serial | 015 |
| Patient Name | Mr. S.K. BANERJEE | Contact No | 26529364 |
| Address | 5A PITAMBAR DEY LANE | Age | 76 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||