Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01803 | Date 13/03/2019 |
| Token No | SM/19-20/8015 12/12/2019 | Serial | 003 |
| Patient Name | Mr. AJIT KUMAR KUNDU | Contact No | 9163159435 |
| Address | 35 K.C. BHATTACHARYA ST | Age | 88 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||