Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03182 | Date 14/10/2019 |
| Token No | SM/18-19/6904 14/10/2019 | Serial | 020 |
| Patient Name | Mr. TAMAL GHOSH | Contact No | 8240564442 |
| Address | 5A LAHIRI ROAD | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||