Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02782 | Date 09/08/2019 |
| Token No | SM/18-19/5573 09/08/2019 | Serial | 022 |
| Patient Name | Mr. SUJAY DAS | Contact No | 9163773722 |
| Address | BSNL OFFICE STAFF, SERAMPORE | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||