Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01253 | Date 20/03/2020 |
| Token No | SM/19-20/3323 20/03/2020 | Serial | 041 |
| Patient Name | Mr. GOUTAM DEY | Contact No | |
| Address | 24 PARGANAS DUTTA PUKUR | Age | 65 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||