Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04033 | Date 22/09/2020 |
| Token No | SM/19-20/8891 22/09/2020 | Serial | 002 |
| Patient Name | Mr. SUPRIYO CHATTERJEE | Contact No | 8961509270 |
| Address | 25 KAILASH CHANDRA CHATTERJEE LANE | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||