Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00610 | Date 24/12/2019 |
| Token No | SM/19-20/1257 24/12/2019 | Serial | 014 |
| Patient Name | Mr. TANMOY BERA | Contact No | |
| Address | 3/D D CRUZE GARDEN LANE PRABASHNAGAR 712203 | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||