Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00349 | Date 07/11/2019 |
| Token No | SM/19-20/892 28/11/2019 | Serial | 004 |
| Patient Name | Mr. TAPAN HALDER | Contact No | |
| Address | MALLICKPARA SERAMPORE | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||