Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00308 | Date 26/10/2019 |
| Token No | SM/19-20/494 26/10/2019 | Serial | 007 |
| Patient Name | Mr. SAMIR DUTTA | Contact No | 9088233017 |
| Address | 65/25/19/C M J ROAD PASCHIM SERAMPORE M PRABASHNAGAR 712249 | Age | 17 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||