Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04009 | Date 14/08/2020 |
| Token No | SM/19-20/8839 14/08/2020 | Serial | 010 |
| Patient Name | Mr. SURESH CHANDRA GHOSH | Contact No | 9051687570 |
| Address | 538 G T ROAD, MANIKTALA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||