Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00197 | Date 19/09/2019 |
| Token No | SM/19-20/233 19/09/2019 | Serial | 004 |
| Patient Name | Mr. ROHIT SHARMA | Contact No | 9804247586 |
| Address | A/6/T TARAPUKUR GOVT QUARTERS MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 142/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||