Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00657 | Date 04/01/2020 |
| Token No | SM/19-20/1388 04/01/2020 | Serial | 010 |
| Patient Name | Mr. RAJESH SANDAKI | Contact No | 9073572198 |
| Address | 65/25/10/A WEST JANNAGAR ROAD SERAMPORE 712249 | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||