Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00541 | Date 12/12/2019 |
| Token No | SM/19-20/1069 12/12/2019 | Serial | 010 |
| Patient Name | Mr. SUMIT DUTTA | Contact No | 7596955737 |
| Address | 65/7/9 MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 23 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||