Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00421 | Date 30/08/2018 |
| Token No | SM/18-19/6899 14/10/2019 | Serial | 015 |
| Patient Name | Mr. SUSANTA BISWAL | Contact No | NOT GIVEN |
| Address | SERAMPORE COLLEGE | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||