Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00736 | Date 15/01/2020 |
| Token No | SM/19-20/1594 15/01/2020 | Serial | 007 |
| Patient Name | Mr. GOPAL SHARAMA | Contact No | |
| Address | 97/Y PROVASNAGER SERAMPORE 712249 | Age | 75 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||