Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01358 | Date 06/04/2020 |
| Token No | SM/19-20/3652 06/04/2020 | Serial | 005 |
| Patient Name | Mr. SUJIT SHAW | Contact No | |
| Address | PROVASNAGER | Age | 41 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||