Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00543 | Date 12/12/2019 |
| Token No | SM/19-20/1074 12/12/2019 | Serial | 015 |
| Patient Name | Mr. LALIT MOHAN DHARA | Contact No | 9836871191 |
| Address | 6 NO SANIPARA LANE SERAMPORE | Age | 54 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||