Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00025 | Date 07/09/2019 |
| Token No | SM/19-20/25 07/09/2019 | Serial | 003 |
| Patient Name | Mr. NEMAI DAS | Contact No | 7890324410 |
| Address | KUMIRJELA ROAD,SERAMPORE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||