Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01108 | Date 29/02/2020 |
| Token No | SM/19-20/2714 29/02/2020 | Serial | 003 |
| Patient Name | Mr. PRASENJIT SAMANTA | Contact No | 8282925768 |
| Address | SUKANTA PALLY SERAMPORE 712203 | Age | 32 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 89 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||