Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00745 | Date 17/01/2020 |
| Token No | SM/19-20/2451 20/02/2020 | Serial | 011 |
| Patient Name | Mr. GAFFAR MALLICK | Contact No | 9088063786 |
| Address | DAKSHIN PARA SERAMPOE | Age | 59 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||