Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00709 | Date 10/01/2020 |
| Token No | SM/19-20/1511 10/01/2020 | Serial | 005 |
| Patient Name | Mr. KALYAN KUMAR SAHA | Contact No | |
| Address | 51A/6 BARABAGAN LANE SERAMPORE | Age | 64 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||