Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00256 | Date 27/09/2019 |
| Token No | SM/19-20/348 27/09/2019 | Serial | 001 |
| Patient Name | Mr. MANOTOSH MONDAL | Contact No | |
| Address | JANGIPUR MURSHIBAD | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||