Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02187 | Date 06/06/2019 |
| Token No | SM/18-19/3981 06/06/2019 | Serial | 006 |
| Patient Name | Mr. SOUMAJIT KUNDU | Contact No | 9433641551 |
| Address | 35 K.C BHATTACHARYA ST | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||