Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00661 | Date 04/01/2020 |
| Token No | SM/19-20/2463 22/02/2020 | Serial | 001 |
| Patient Name | Mr. NETAI NAG | Contact No | 7449911910 |
| Address | 30/66 TARAPUKUR COLONY SERAMPORE 712203 | Age | 57 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||