Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01733 | Date 28/02/2019 |
| Token No | SM/18-19/2640 28/02/2019 | Serial | 024 |
| Patient Name | Mr. ASIT KUMAR PAL | Contact No | NOT GIVEN |
| Address | NAGA SERAMPORE | Age | 60 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||