Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03362 | Date 14/11/2019 |
| Token No | SM/18-19/7363 14/11/2019 | Serial | 011 |
| Patient Name | Mr. DULAL KUMAR KUNDU | Contact No | 7044096209 |
| Address | 3A/1 ACHARYA K C BHATTCHARYA STREET | Age | 83 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||