Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01764 | Date 08/03/2019 |
| Token No | SM/18-19/6977 18/10/2019 | Serial | 002 |
| Patient Name | Mr. MUKUNDA PAL | Contact No | NOT GIVEN |
| Address | 22 KAILASH CHATTERJEE LANE | Age | 57 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||