Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00510 | Date 05/12/2019 |
| Token No | SM/19-20/978 05/12/2019 | Serial | 005 |
| Patient Name | Mr. SAMBHU ADHIKAREY | Contact No | |
| Address | PROVASNAGER SERAMPORE | Age | 59 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||