Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02129 | Date 28/05/2019 |
| Token No | SM/18-19/3831 28/05/2019 | Serial | 005 |
| Patient Name | Mr. SUBHASIS BHATTACHARYA | Contact No | 9674513110 |
| Address | 117 G.T.ROAD MANIKTALA | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||