Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03301 | Date 31/10/2019 |
| Token No | SM/18-19/7184 31/10/2019 | Serial | 001 |
| Patient Name | Mr. GOPAL GHOSH | Contact No | 9874205698 |
| Address | 37B J N LAHIRI ROAD | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||