Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00852 | Date 03/02/2020 |
| Token No | SM/19-20/1966 04/02/2020 | Serial | 003 |
| Patient Name | Mr. RAJU DEY | Contact No | 9748049232 |
| Address | 119 GURU GARDEN ROAD SERAMPORE 712249 | Age | 33 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||