Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00198 | Date 19/09/2019 |
| Token No | SM/19-20/236 19/09/2019 | Serial | 007 |
| Patient Name | Mr. SRIBASH CHANDRA SAHA | Contact No | 7890664088 |
| Address | 30/19 TARAPUKUR LANE SERAMPORE 712203 | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||