Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02177 | Date 04/06/2019 |
| Token No | SM/18-19/4121 13/06/2019 | Serial | 011 |
| Patient Name | Mr. ABHIJIT MAJUMDAR | Contact No | 7044291414 |
| Address | 121 THAKURBATI ST | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||