Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00789 | Date 22/01/2020 |
| Token No | SM/19-20/1741 22/01/2020 | Serial | 021 |
| Patient Name | Mr. JAYANTA KUMAR GHOSH | Contact No | 9051608532 |
| Address | TRIBENI KALNA ROAD | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||