Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00628 | Date 30/12/2019 |
| Token No | SM/19-20/1308 30/12/2019 | Serial | 011 |
| Patient Name | Mr. RAJU CHOWDHURY | Contact No | 9830844995 |
| Address | 36/X TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||