Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02222 | Date 10/06/2019 |
| Token No | SM/18-19/4062 10/06/2019 | Serial | 030 |
| Patient Name | Mr. SUBHASISH MUKHERJEE | Contact No | 9836290644 |
| Address | 34 DOSTI LANE | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||