Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00551 | Date 13/12/2019 |
| Token No | SM/19-20/1086 13/12/2019 | Serial | 012 |
| Patient Name | Mr. SANDIP BAIRAGI | Contact No | 8013240834 |
| Address | 26 SANIPARA LANE SERAMPORE | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||