Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03188 | Date 15/10/2019 |
| Token No | SM/18-19/6918 15/10/2019 | Serial | 010 |
| Patient Name | Mr. RAJU KUMAR | Contact No | 9051871627 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||