Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01859 | Date 04/04/2019 |
| Token No | SM/18-19/7646 22/11/2019 | Serial | 005 |
| Patient Name | Mr. SANTOSH CHATTERJEE | Contact No | 9051231165 |
| Address | JOLKOL WORKER | Age | 52 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||