Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00298 | Date 23/10/2019 |
| Token No | SM/19-20/2089 07/02/2020 | Serial | 054 |
| Patient Name | Mr. CHITTARANJAN DAS | Contact No | 8420661617 |
| Address | 65/8 PRABASHNAGAR SERAMPORE 712249 | Age | 76 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||