Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01341 | Date 06/12/2018 |
| Token No | SM/18-19/2358 05/02/2019 | Serial | 018 |
| Patient Name | Mr. GOURAB BANERJEE | Contact No | 9681802222 |
| Address | 35 R B SATRANI | Age | 27 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||