Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00127 | Date 16/09/2019 |
| Token No | SM/19-20/137 16/09/2019 | Serial | 001 |
| Patient Name | Mr. SHANKAR DAS | Contact No | 8981994377 |
| Address | TARAPUKUR GOVT QUATER MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 170/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||