Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01257 | Date 01/11/2018 |
| Token No | SM/18-19/1725 01/11/2018 | Serial | 002 |
| Patient Name | Mr. BAIDYANATH DAS | Contact No | 8697028307 |
| Address | 39/C NILMONI GHOSH LANE, MAHESH | Age | 77 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||