Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03364 | Date 14/11/2019 |
| Token No | SM/18-19/7368 14/11/2019 | Serial | 016 |
| Patient Name | Mr. ASJGAR MALLICK | Contact No | 8961801825 |
| Address | 49A DR NANILAL BHATTCHARYA STREET | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||