Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00154 | Date 08/08/2018 |
| Token No | SM/18-19/162 08/08/2018 | Serial | 028 |
| Patient Name | Mr. BACCHU MONDAL | Contact No | NOT GIVEN |
| Address | SERAMPORE | Age | 36 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 136/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||