Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01673 | Date 15/02/2019 |
| Token No | SM/19-20/8260 06/01/2020 | Serial | 029 |
| Patient Name | Mr. SUKUMAR DAS | Contact No | 9163101741 |
| Address | 27 DEY STREET | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||