Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00798 | Date 25/01/2020 |
| Token No | SM/19-20/3494 28/03/2020 | Serial | 017 |
| Patient Name | Mr. SUNIL CHANDRA MALAKAR | Contact No | 8697353380 |
| Address | 30/28 TARAPUKUR LANE SERAMPORE 712203 | Age | 85 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||