Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00246 | Date 25/09/2019 |
| Token No | SM/19-20/334 25/09/2019 | Serial | 010 |
| Patient Name | Mr. HIMANISH SAMADDAR | Contact No | 8697364267 |
| Address | 45 PROVASNAGER SERAMPORE 712249 | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||