Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00679 | Date 06/01/2020 |
| Token No | SM/19-20/2511 24/02/2020 | Serial | 016 |
| Patient Name | Mr. BIDUR CHANDRA DALUI | Contact No | 8420337703 |
| Address | 34/B/19 B B GHOSH ROAD SERAMPORE 712203 | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||