Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03222 | Date 18/10/2019 |
| Token No | SM/18-19/6995 18/10/2019 | Serial | 020 |
| Patient Name | Mr. TARUN CHAKRABORTY | Contact No | 6290437991 |
| Address | 43/20/H/2 PRAVASH NAGAR | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||