Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02354 | Date 25/06/2019 |
| Token No | SM/18-19/4457 25/06/2019 | Serial | 045 |
| Patient Name | Mr. SUVAJIT PAL | Contact No | NOT GIVEN |
| Address | 22 KAILASH CHATTEJEE LANE | Age | 23 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||