Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00248 | Date 25/09/2019 |
| Token No | SM/19-20/336 25/09/2019 | Serial | 012 |
| Patient Name | Mr. SAMBHUNATH DALAPATI | Contact No | 7890495537 |
| Address | 65/25/50 PROVASNAGER SERAMPORE 712249 | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||