Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02497 | Date 18/07/2019 |
| Token No | SM/18-19/4847 18/07/2019 | Serial | 025 |
| Patient Name | Mr. SUMAN KARMAKAR | Contact No | 9093909154 |
| Address | 56 THAKUR BATI STREET | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||