Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02539 | Date 22/07/2019 |
| Token No | SM/18-19/4941 22/07/2019 | Serial | 034 |
| Patient Name | Mr. SONU KUMAR | Contact No | NOT GIVEN |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||