Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02387 | Date 01/07/2019 |
| Token No | SM/18-19/4727 11/07/2019 | Serial | 008 |
| Patient Name | Mr. SUBHAS KUMAR DAS | Contact No | 9051871627 |
| Address | 18 KAILASH CHATTERJEE LANE | Age | 21 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||