Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00500 | Date 03/12/2019 |
| Token No | SM/19-20/965 03/12/2019 | Serial | 030 |
| Patient Name | Mr. LOKENATH CHOWDHURY | Contact No | 9748513823 |
| Address | 38/D B B GHOSH ROAD SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||