Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 00332 | Date 05/11/2019 |
| Token No | SM/19-20/815 25/11/2019 | Serial | 001 |
| Patient Name | Mr. TARAK BASAK | Contact No | 8442963110 |
| Address | NILMONI GHOSH LINE SERAMPORE | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||