Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00659 | Date 04/01/2020 |
| Token No | SM/19-20/1390 04/01/2020 | Serial | 012 |
| Patient Name | Mr. SOMNATH GHOSH | Contact No | 8100143860 |
| Address | 55 ROYLAND ROAD SERAMPORE 712201 | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||