Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00962 | Date 14/02/2020 |
| Token No | SM/19-20/2266 14/02/2020 | Serial | 051 |
| Patient Name | Mr. MONSA PATWA | Contact No | |
| Address | GORAMARA SERAMPORE | Age | 62 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||