Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00286 | Date 22/10/2019 |
| Token No | SM/19-20/449 22/10/2019 | Serial | 018 |
| Patient Name | Mr. SIMANTA MONDAL | Contact No | 8981831530 |
| Address | 13/44 B B GHOSH ROAD PRABASHNAGAR | Age | 44 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||