Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00461 | Date 26/11/2019 |
| Token No | SM/19-20/1233 23/12/2019 | Serial | 005 |
| Patient Name | Mr. SONA DAS | Contact No | 8100689004 |
| Address | SOCIETY MATH B B GHOSH ROAD SERAMPORE 712203 | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||