Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03121 | Date 26/09/2019 |
| Token No | SM/18-19/6692 26/09/2019 | Serial | 003 |
| Patient Name | Mr. SAGNIK KUNDU | Contact No | 9836640631 |
| Address | 4 DEY STREET | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||