Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00756 | Date 17/01/2020 |
| Token No | SM/19-20/3396 25/03/2020 | Serial | 002 |
| Patient Name | Mr. KALIPADA DAS | Contact No | 9230393660 |
| Address | 16 NEW MAHESH SERAMPORE 712203 | Age | 92 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||