Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02485 | Date 16/07/2019 |
| Token No | SM/18-19/4812 16/07/2019 | Serial | 028 |
| Patient Name | Mr. NILTU MANDAL | Contact No | NOT GIVEN |
| Address | 24 K.C. BHATTACHARYA ST | Age | 36 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||