Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03544 | Date 05/12/2019 |
| Token No | SM/19-20/7851 05/12/2019 | Serial | 001 |
| Patient Name | Mr. SANDIP KUMAR SHA | Contact No | 9477199012 |
| Address | 5/2/C GOPAL GANGULY LANE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||