Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01721 | Date 28/02/2019 |
| Token No | SM/18-19/2618 28/02/2019 | Serial | 002 |
| Patient Name | Mr. SUBHASISH BHATTACHARYA | Contact No | 9674513110 |
| Address | 117 G T ROAD MANIK TALA | Age | 41 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||