Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00344 | Date 05/11/2019 |
| Token No | SM/19-20/3385 24/03/2020 | Serial | 016 |
| Patient Name | Mr. KASHINATH DAS | Contact No | 9038647165 |
| Address | 1/E DINEN BHATTACHARJEE SARANI PRABASHNAGAR | Age | 86 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||