Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03990 | Date 14/07/2020 |
| Token No | SM/19-20/8818 14/07/2020 | Serial | 016 |
| Patient Name | Mr. DIPU DAS | Contact No | 9830116546 |
| Address | 9/11 KOLKATA | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||