Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01541 | Date 03/01/2019 |
| Token No | SM/18-19/6451 16/09/2019 | Serial | 011 |
| Patient Name | Mr. ASHOK CHATTERJEE | Contact No | 9477931661 |
| Address | 22E/1 JANNAGAR ROAD | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||