Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00178 | Date 17/09/2019 |
| Token No | SM/19-20/264 21/09/2019 | Serial | 003 |
| Patient Name | Mr. SANKAR DEY | Contact No | 9088516793 |
| Address | 20G/1 DINEN BHATTACHARYA SARANI PRABASHNAGAR SERAMPORE 712249 | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 87 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||