Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02245 | Date 13/06/2019 |
| Token No | SM/18-19/4125 13/06/2019 | Serial | 015 |
| Patient Name | Mr. DULAL CHANDRA GHOSH | Contact No | 9007997649 |
| Address | 2 DOCTOR CHATTERJEE LANE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||