Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00328 | Date 28/08/2018 |
| Token No | SM/18-19/363 28/08/2018 | Serial | 030 |
| Patient Name | Mr. SUNIL CHATTERJEE | Contact No | |
| Address | KASHI DOCTOR LANE | Age | 60 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||