Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00499 | Date 20/08/2018 |
| Token No | SM/18-19/7344 11/11/2019 | Serial | 028 |
| Patient Name | Mr. SWAGOTO KUNDU | Contact No | 7980825462 |
| Address | 584/A G T ROAD MANIKTALA | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||