Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00403 | Date 19/11/2019 |
| Token No | SM/19-20/730 19/11/2019 | Serial | 010 |
| Patient Name | Mr. RAJU DAS | Contact No | 8420379977 |
| Address | 91 NEW MAHESH SERAMPORE 712203 | Age | 34 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||