Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03219 | Date 18/10/2019 |
| Token No | SM/18-19/6989 18/10/2019 | Serial | 014 |
| Patient Name | Mr. INDRAJIT GHOSAL | Contact No | 8296583335 |
| Address | 43B BHAGIRATHI LANE | Age | 48 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||