Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01502 | Date 28/04/2020 |
| Token No | SM/19-20/3951 28/04/2020 | Serial | 001 |
| Patient Name | Mr. SITOL DOLUI | Contact No | |
| Address | 38B B B GHOSH ROAD MALLICKPARA SERAMPORE 712203 | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||