Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01545 | Date 03/01/2019 |
| Token No | SM/18-19/2203 03/01/2019 | Serial | 024 |
| Patient Name | Mr. SANTI KR MANNA | Contact No | NOT GIVEN |
| Address | 52/1 BHAGIRATHI LANE | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||