Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00422 | Date 23/11/2019 |
| Token No | SM/19-20/788 23/11/2019 | Serial | 009 |
| Patient Name | Mr. PANCHU KARMAKAR | Contact No | 9051848537 |
| Address | 65/24/4 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 53 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||