Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02333 | Date 21/06/2019 |
| Token No | SM/18-19/7287 07/11/2019 | Serial | 004 |
| Patient Name | Mr. SUBHAJIT GANGULY | Contact No | 9007769958 |
| Address | 586/A G T ROAD, MANIKTALA | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||