Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00151 | Date 16/09/2019 |
| Token No | SM/19-20/165 16/09/2019 | Serial | 029 |
| Patient Name | Mr. SUKUMAR SANTRA | Contact No | 7439080349 |
| Address | 12/C TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 37 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||