Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00694 | Date 09/01/2020 |
| Token No | SM/19-20/1476 09/01/2020 | Serial | 005 |
| Patient Name | Mr. LALTU MAJUMDER | Contact No | |
| Address | 65/20/37 PRABASHNAGAR SERAMPORE 712249 | Age | 41 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||