Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00951 | Date 14/02/2020 |
| Token No | SM/19-20/2247 14/02/2020 | Serial | 032 |
| Patient Name | Mr. SHUBHAM KARMAKAR | Contact No | 9051848537 |
| Address | 65/24/4 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 14 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||