Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00074 | Date 11/09/2019 |
| Token No | SM/19-20/3489 28/03/2020 | Serial | 012 |
| Patient Name | Mr. MAINAK SAHA | Contact No | 9123897433 |
| Address | 139/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||