Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03664 | Date 03/01/2020 |
| Token No | SM/19-20/8215 03/01/2020 | Serial | 013 |
| Patient Name | Mr. MONOBINA PAL | Contact No | 7003282065 |
| Address | 17 CHATTERJEE LANE | Age | 31 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||