Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00615 | Date 27/12/2019 |
| Token No | SM/19-20/1270 27/12/2019 | Serial | 004 |
| Patient Name | Mr. SAILO PAL | Contact No | |
| Address | HARIPARA LANE SERAMPORE 712203 | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||