Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00777 | Date 21/01/2020 |
| Token No | SM/19-20/1710 21/01/2020 | Serial | 022 |
| Patient Name | Mr. SAMIR KUMAR MAJHI | Contact No | 8697353172 |
| Address | HARI PARA SERAMPORE | Age | 42 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 79 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||