Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00107 | Date 13/09/2019 |
| Token No | SM/19-20/681 15/11/2019 | Serial | 017 |
| Patient Name | Mr. JOYDEV DAS | Contact No | 8276940809 |
| Address | 34 RAY M C LAHIRI BAHADUR STREET SERAMPORE 712204 | Age | 76 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||