Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01050 | Date 24/02/2020 |
| Token No | SM/19-20/2820 05/03/2020 | Serial | 004 |
| Patient Name | Mr. BIPUL CHAKRABORTY | Contact No | 8420352179 |
| Address | 65/5 MAHESH JANNAGAR ROAD PRABASHNAGAR 712249 | Age | 68 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||