Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00230 | Date 25/08/2018 |
| Token No | SM/18-19/306 11/08/2018 | Serial | 024 |
| Patient Name | Mr. PRADIP JANA | Contact No | |
| Address | SERAMPORE | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||