Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00470 | Date 27/11/2019 |
| Token No | SM/19-20/886 27/11/2019 | Serial | 002 |
| Patient Name | Mr. SANTI RANJAN SAHA | Contact No | |
| Address | SUKANTA PALLY PRABASHNAGAR | Age | 37 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||