Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00609 | Date 24/12/2019 |
| Token No | SM/19-20/1256 24/12/2019 | Serial | 013 |
| Patient Name | Mr. TAPAN CHAKRABORT | Contact No | 9830829746 |
| Address | 281/L/A NAGARMORE GHOSALPARA BAIDYABATI 712203 | Age | 54 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||