Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01732 | Date 28/02/2019 |
| Token No | SM/18-19/2639 28/02/2019 | Serial | 023 |
| Patient Name | Mr. TARAPADA JANA | Contact No | NOT GIVEN |
| Address | TARAKESWAR | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||