Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01934 | Date 18/04/2019 |
| Token No | SM/18-19/3562 07/05/2019 | Serial | 016 |
| Patient Name | Mr. SOUMYA CHAKRABORTY | Contact No | 8961668828 |
| Address | 1/2 CHATTERJEE LANE | Age | 19 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||