Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00131 | Date 16/09/2019 |
| Token No | SM/19-20/141 16/09/2019 | Serial | 005 |
| Patient Name | Mr. BABLU ACHARYA | Contact No | 9836985925 |
| Address | A/17/X TARAPUKUR GOVT QUARTERS MALLICKPARA SERAMPORE 712203 | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||