Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00477 | Date 29/11/2019 |
| Token No | SM/19-20/1062 12/12/2019 | Serial | 003 |
| Patient Name | Mr. SWAPAN KUMAR DUTTA | Contact No | 9143617436 |
| Address | 65/7/9 MAHESH JANNAGAR ROAD PROVASNAGER SERAMPORE 712249 | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||