Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00776 | Date 21/01/2020 |
| Token No | SM/19-20/1709 21/01/2020 | Serial | 021 |
| Patient Name | Mr. SURESH BHUIYA | Contact No | 7890171687 |
| Address | 4 B B GHOSH ROAD SERAMPORE 712203 | Age | 37 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||