Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01126 | Date 04/03/2020 |
| Token No | SM/19-20/2811 04/03/2020 | Serial | 042 |
| Patient Name | Mr. AJOY SHUILI | Contact No | 8981540617 |
| Address | B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||