Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01219 | Date 18/03/2020 |
| Token No | SM/19-20/3199 18/03/2020 | Serial | 001 |
| Patient Name | Mr. SURAJIT DOLUI | Contact No | 8296454513 |
| Address | 34/B/19 B B GHOSH ROAD SERAMPORE 712203 | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||