Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02483 | Date 16/07/2019 |
| Token No | SM/19-20/7865 05/12/2019 | Serial | 015 |
| Patient Name | Mr. HEMANTA KARMAKAR | Contact No | 9093909154 |
| Address | 56 THAKUR BATI STREET | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||