Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01787 | Date 15/03/2019 |
| Token No | SM/18-19/6371 12/09/2019 | Serial | 018 |
| Patient Name | Mr. GOUTAM KUNDU | Contact No | 26621236 |
| Address | 1 A K C BHATTACHARJEE STREET | Age | 60 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||