Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03111 | Date 24/09/2019 |
| Token No | SM/18-19/6659 24/09/2019 | Serial | 014 |
| Patient Name | Mr. PRITTHISH CHATTERJEE | Contact No | 9432543460 |
| Address | 53/I J.N. LAHIRI ROAD | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||