Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03378 | Date 14/11/2019 |
| Token No | SM/18-19/7397 14/11/2019 | Serial | 045 |
| Patient Name | Mr. PANCHU GOPAL KARMAKAR | Contact No | 9903913146 |
| Address | 58 CHATTERJEE PARA | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||