Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01235 | Date 19/03/2020 |
| Token No | SM/22-23/7972 04/04/2023 | Serial | 012 |
| Patient Name | Mr. CHANDI DAS | Contact No | 9674823693 |
| Address | SOCIETY MATH B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 62 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||