Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00375 | Date 14/11/2019 |
| Token No | SM/19-20/659 14/11/2019 | Serial | 032 |
| Patient Name | Mr. SANKAR DAS | Contact No | 9163171620 |
| Address | 60 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 40 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||