Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00779 | Date 21/01/2020 |
| Token No | SM/19-20/3057 13/03/2020 | Serial | 035 |
| Patient Name | Mr. ANGIKAR SAMANTA | Contact No | 9831812182 |
| Address | PROVASNAGER | Age | 13 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||