Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01334 | Date 01/04/2020 |
| Token No | SM/19-20/3586 01/04/2020 | Serial | 027 |
| Patient Name | Mr. SUJIT SING | Contact No | 9051571979 |
| Address | 55 NO ROY LAND ROAD SERAMPORE 712201 | Age | 36 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||