Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00978 | Date 17/02/2020 |
| Token No | SM/19-20/3390 24/03/2020 | Serial | 021 |
| Patient Name | Mr. MAHADEB CHAKRABORTY | Contact No | 9143614958 |
| Address | 43/32/A SERAMPORE PRABASHNAGAR 712249 | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||