Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01564 | Date 04/05/2020 |
| Token No | SM/19-20/4086 04/05/2020 | Serial | 033 |
| Patient Name | Mr. BADAL SHUILI | Contact No | |
| Address | D CRUZE GARDEN LANE SERAMPORE 712203 | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||