Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00950 | Date 14/02/2020 |
| Token No | SM/19-20/2382 18/02/2020 | Serial | 018 |
| Patient Name | Mr. SANJAY KUMAR PAL | Contact No | 9123013641 |
| Address | 2/C TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||