Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00505 | Date 04/12/2019 |
| Token No | SM/19-20/1005 06/12/2019 | Serial | 026 |
| Patient Name | Mr. ARUP DAS | Contact No | 9038458704 |
| Address | 30/34 TARAPUKUR LANE SERAMPORE 712203 | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||