Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01303 | Date 27/11/2018 |
| Token No | SM/18-19/4866 19/07/2019 | Serial | 001 |
| Patient Name | Mr. SANJIT SARKAR | Contact No | 9051904367 |
| Address | 3/2 K C MUKHERJEE STREET, CHATRA | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||