Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03474 | Date 22/11/2019 |
| Token No | SM/18-19/7667 22/11/2019 | Serial | 026 |
| Patient Name | Mr. BIRJENDU RAKSHIT | Contact No | 9674510989 |
| Address | 49 PATUA PARA LANE | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||