Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03735 | Date 14/01/2020 |
| Token No | SM/21-22/1006 31/08/2021 | Serial | 028 |
| Patient Name | Mr. SWAPAN DAS | Contact No | NOT GIVEN |
| Address | VILL: NARAYANPUR, POST: LAXMIPUL, 24 PARGANAS(N) | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||