Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03218 | Date 18/10/2019 |
| Token No | SM/18-19/6988 18/10/2019 | Serial | 013 |
| Patient Name | Mr. SRIJIT GHOSAL | Contact No | 6291488169 |
| Address | 43B BHAGIRATHI LANE | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||