Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03254 | Date 21/10/2019 |
| Token No | SM/18-19/7080 21/10/2019 | Serial | 047 |
| Patient Name | Mr. PANCHANAN RAKSHIT | Contact No | 9830711320 |
| Address | 47 BANERJEE PARA | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||