Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00221 | Date 23/09/2019 |
| Token No | SM/19-20/285 23/09/2019 | Serial | 004 |
| Patient Name | Mr. MANOJ KR GIRI | Contact No | 7890491336 |
| Address | 165/A NEW MAHESH SERAMPORE 712203 | Age | 50 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||