Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02816 | Date 16/08/2019 |
| Token No | SM/18-19/5659 16/08/2019 | Serial | 027 |
| Patient Name | Mr. BIPADTARAN BERA | Contact No | 9874360230 |
| Address | 12 JAGOMOHAN LAHIRI LANE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||