Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02947 | Date 30/08/2019 |
| Token No | SM/18-19/6486 16/09/2019 | Serial | 046 |
| Patient Name | Mr. APU DAS | Contact No | 8017802770 |
| Address | 32 N L BHATTACHARJEE STREET | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||