Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00363 | Date 14/11/2019 |
| Token No | SM/19-20/3643 04/04/2020 | Serial | 022 |
| Patient Name | Mr. SUKUMAR CHOWDHURY | Contact No | 9748513823 |
| Address | 38/D B B GHOSH ROAD SERAMPORE 712203 | Age | 50 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||