Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00617 | Date 27/12/2019 |
| Token No | SM/19-20/1592 15/01/2020 | Serial | 005 |
| Patient Name | Mr. ASHOKE SHIULI | Contact No | 8981540617 |
| Address | 3G D CRUZE GARDEN LANE SERAMPORE 712203 | Age | 57 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||