Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03793 | Date 28/01/2020 |
| Token No | SM/19-20/8526 28/01/2020 | Serial | 026 |
| Patient Name | Mr. ASHIS KONAR | Contact No | 9735114551 |
| Address | SERAMPORE JOLKOL | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||