Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04595 | Date 13/07/2021 |
| Token No | SM/21-22/598 13/07/2021 | Serial | 013 |
| Patient Name | Mr. PRASANTA DAS | Contact No | 8100364473 |
| Address | 41 NANILAL BHATTACHARJEE STREET | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||