Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00177 | Date 17/09/2019 |
| Token No | SM/19-20/1366 03/01/2020 | Serial | 006 |
| Patient Name | Mr. SANTIRANJAN BANIK | Contact No | 8240633152 |
| Address | 30/46 TARAPUKUR LANE,SERAMPORE 712203 | Age | 78 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||