Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02206 | Date 07/06/2019 |
| Token No | SM/18-19/4018 07/06/2019 | Serial | 015 |
| Patient Name | Mr. V. KHAI RODINGA | Contact No | 9436354260 |
| Address | SERAMPORE COLLEGE | Age | 39 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||