Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03280 | Date 23/10/2019 |
| Token No | SM/18-19/7136 23/10/2019 | Serial | 007 |
| Patient Name | Mr. SANKAR ROUTH | Contact No | 9836798991 |
| Address | 11B HOSPITAL LANE SRERAMPORE | Age | 42 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||