Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00364 | Date 14/11/2019 |
| Token No | SM/19-20/631 14/11/2019 | Serial | 004 |
| Patient Name | Mr. DEBASIS NASKAR | Contact No | 6290488224 |
| Address | BISWAKABIPARA SERAMPORE | Age | 62 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||