Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00524 | Date 09/12/2019 |
| Token No | SM/19-20/1022 09/12/2019 | Serial | 003 |
| Patient Name | Mr. MAHENDRA DAS | Contact No | |
| Address | 30/34 TARAPUKUR COLONY SERAMPORE | Age | 58 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||