Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00821 | Date 28/01/2020 |
| Token No | SM/19-20/1857 28/01/2020 | Serial | 012 |
| Patient Name | Mr. SANJAY SHAW | Contact No | 8961447501 |
| Address | 2 J L N SARANI KONNAGAR M 712235 | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||