Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00823 | Date 28/01/2020 |
| Token No | SM/19-20/1867 28/01/2020 | Serial | 022 |
| Patient Name | Mr. SAMIR SENGUPTA | Contact No | 7450876704 |
| Address | C/129/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||