Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00085 | Date 12/09/2019 |
| Token No | SM/19-20/672 15/11/2019 | Serial | 008 |
| Patient Name | Mr. RAMESH CHANDRA SHAW | Contact No | 8420291433 |
| Address | 97/F/5 PRABASHNAGAR SERAMPORE 712249 | Age | 82 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||