Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00140 | Date 16/09/2019 |
| Token No | SM/19-20/1662 18/01/2020 | Serial | 012 |
| Patient Name | Mr. DILIP SAHA | Contact No | 9874290076 |
| Address | 35/F SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||