Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03568 | Date 06/12/2019 |
| Token No | SM/19-20/7909 06/12/2019 | Serial | 023 |
| Patient Name | Mr. SOMNATH CHANDRA | Contact No | 9674486340 |
| Address | 33/A DEY BAGAN LANE | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||