Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00632 | Date 31/12/2019 |
| Token No | SM/19-20/1330 31/12/2019 | Serial | 013 |
| Patient Name | Mr. ABHIJIT KUMAR DOLUI | Contact No | 8296454513 |
| Address | 34/B/19 B B GHOSH ROAD SERAMPORE 712203 | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||