Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00872 | Date 05/02/2020 |
| Token No | SM/19-20/3094 14/03/2020 | Serial | 031 |
| Patient Name | Mr. AJIT MONDAL | Contact No | 9330944803 |
| Address | AHIRAN BASANTAPUR MURSHIDABAD 742201 | Age | 27 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||