Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01419 | Date 15/04/2020 |
| Token No | SM/19-20/3778 15/04/2020 | Serial | 005 |
| Patient Name | Mr. ASIT PAL | Contact No | |
| Address | NAGA MORE SERAMPORE | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||