Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00264 | Date 27/09/2019 |
| Token No | SM/19-20/362 27/09/2019 | Serial | 015 |
| Patient Name | Mr. TALIB ALI | Contact No | 9681979480 |
| Address | 117 2NO RAJYADHARPUR GOVT COLONY,SERAMPORE | Age | 58 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||