Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01099 | Date 28/02/2020 |
| Token No | SM/19-20/2667 28/02/2020 | Serial | 006 |
| Patient Name | Mr. RAMESWAR SHARMA | Contact No | 7890284127 |
| Address | 34/B/11 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 60 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||