Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00090 | Date 06/08/2018 |
| Token No | SM/18-19/4151 14/06/2019 | Serial | 009 |
| Patient Name | Mr. TAPAN KUNDU | Contact No | 8902536138 |
| Address | 584/A G.T.ROAD MANIKTALA, SERAMPORE | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||