Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03492 | Date 28/11/2019 |
| Token No | SM/19-20/7733 28/11/2019 | Serial | 035 |
| Patient Name | Mr. SHYAMSUNDAR DUTTA | Contact No | 8133598114 |
| Address | 54 G T ROAD, KALITALA | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||