Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03435 | Date 19/11/2019 |
| Token No | SM/18-19/7534 19/11/2019 | Serial | 031 |
| Patient Name | Mr. SAYANTAN DUTTA | Contact No | 7278805880 |
| Address | 7 PATUA PARA | Age | 26 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||