Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02522 | Date 19/07/2019 |
| Token No | SM/18-19/6500 16/09/2019 | Serial | 060 |
| Patient Name | Mr. BALARAM CH NATH | Contact No | 9432076660 |
| Address | 39 G C BHATTACHARYA LANE | Age | 44 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||