Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04002 | Date 14/08/2020 |
| Token No | SM/19-20/8832 14/08/2020 | Serial | 003 |
| Patient Name | Mr. SOUMENDRA NATH RAKSHIT | Contact No | 8697607589 |
| Address | 153 THAKUR BATI STREET | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||