Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03617 | Date 16/12/2019 |
| Token No | SM/19-20/8075 16/12/2019 | Serial | 006 |
| Patient Name | Mr. DIPAK PAL | Contact No | 8981580112 |
| Address | 17 KAILASH CHATTERJEE LANE | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||