Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03571 | Date 06/12/2019 |
| Token No | SM/19-20/7917 06/12/2019 | Serial | 031 |
| Patient Name | Mr. DEBASIS CHATTERJEE | Contact No | 9433842005 |
| Address | 51 BHAGIRATHI LANE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||