Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00840 | Date 01/02/2020 |
| Token No | SM/19-20/1917 01/02/2020 | Serial | 030 |
| Patient Name | Mr. RAJ KUMAR KANTI | Contact No | 7980854128 |
| Address | 9/A TARA PUKUR LANE SERAMPORE 712203 | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||