Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00051 | Date 04/08/2018 |
| Token No | SM/18-19/6793 30/09/2019 | Serial | 018 |
| Patient Name | Mr. FALGUNI BHATTACHARYA | Contact No | 9831925874 |
| Address | 30,K.C BHATTACHARYA STREET | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||