Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01905 | Date 09/04/2019 |
| Token No | SM/18-19/4605 05/07/2019 | Serial | 013 |
| Patient Name | Mr. DIBYENDU MUKHERJEE | Contact No | 9163446450 |
| Address | 25B KAILASH CHATTERJEE LANE | Age | 72 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||