Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03498 | Date 29/11/2019 |
| Token No | SM/19-20/7747 29/11/2019 | Serial | 010 |
| Patient Name | Mr. TAPAN KUMAR BISWAS | Contact No | 8904941971 |
| Address | 1 KASHI DAKTAR LANE | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||